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Clinical Quality Assurance Coordinator - Lead


ExamWorks


Location

Rockville, MD | United States


Job description

No matter where you are in your nursing career, we'd love to hear from you because  MCMC is seeking a *Remote* Clinical QA Coordinator Lead (LPN/RN)to join our team! 

 

The Clinical Quality Assurance Coordinator Lead is responsible to assist in the daily workflow of the department, analyze medical records and handle quality assurance questions on medical necessity, utilization review and peer review files as needed. This position is required to have a complete understanding of the duties required below and provide overall direction and support to the Quality Assurance Department.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM THIS JOB SUCCESSFULLY INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING :

SUPERVISORY RESPONSIBILITIES

Directly support and when required supervise and carry out supervisory responsibilities in accordance with ExamWorks’ policies and applicable laws. Responsibilities include, but are not limited to:

EDUCATION AND/OR EXPERIENCE 

Bachelor degree in nursing or related field; or minimum five years related experience; or equivalent combination of education and experience. Knowledge of the insurance industry, preferably claims management, relative to workers' compensation, no-fault, liability, and disability is desired.

 

CERTIFICATES, LICENSES, REGISTRATIONS

Registered Nursing license preferred, but not required in all business units of the company.

 

QUALIFICATIONS 

MCMC completes over 100,000 reviews each year for more than 400 clients, including almost all of the nation’s largest Health Plans, PBMs, Disability Carriers, TPAs, UR companies, Self-Insured Employers, Taft-Hartley Plans and Government Organizations.

 

MCMC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

 

MCMC offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

 

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans


Job tags

Full timeLocal areaRemote job


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