Clinical Quality Assurance Specialist, RN
New
W
Wider CircleHealthcare
St. Louis, Missouri, United States. Louisville, Kentucky, United States. Indianapolis, Indiana, United States. Nashville, Tennessee, United States. Tampa, Florida, United States. Columbus, Ohio, United StatesFull-TimeMiddle
Salary80,000 - 95,000 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- At least 3 years of clinical experience
- Required Skills
- Data AnalysisOperations ManagementEHR
Requirements
- Active, unrestricted RN, NP, LPN, or LCSW license (multi-state or compact license preferred).
- At least 3 years of clinical experience, ideally including operations or quality experience.
- Hands-on experience reviewing charts for billing compliance.
- Strong understanding of documentation rules for Medicare, Medicaid, and value-based care.
- Operations mindset with the ability to build systems, trackers, and automated processes.
- Tech-forward attitude with the ability to quickly learn new tools and leverage AI.
- Strong data analysis skills to pull, sort, and interpret QA data.
- Proficiency with EHR systems, Slack, and Google Suite.
- Strong project management, prioritization, and collaboration skills.
- Openness to giving and receiving direct, honest feedback.
Responsibilities
- Review clinical charts on a regular schedule for both new hires and current staff.
- Pull random samples and maintain monthly QA records and audit documentation.
- Ensure documentation and billing compliance to meet standards with clear clinical reasoning.
- Report patterns and gaps to leadership with suggested fixes.
- Partner with Operations, Billing, and Training teams to implement workflow and automation fixes.
- Develop a clinical quality scoring system for coaching and performance reviews.
- Own and grow the overall QA program, including adverse event reporting and audit support.
View Full Description & ApplyYou'll be redirected to the employer's site
