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Clinical Quality Assurance Supervisor

2 weeks, 1 day ago
United States
Full-time
Senior
Manual QA Tester
Quality Assurance and Testing
Apply Now
Dane Street

Dane Street

Dane Street provides independent medical examination and peer review services tailored for the insurance industry, focusing on areas such as workers' compensation, disability, and auto liability, while emphasizing quality, compliance, and timely delive...

Insurance
251-1K
Founded 2008
View All Jobs 60

Description

  • Oversee the review of physician reports and accompanying medical records to ensure reports are complete, accurate, and consistent with medical evidence.
  • Assign QA staff to files and define file-handling responsibilities across the team.
  • Supervise assigned staff and manage the File Review Board to maintain a timely and accurate review process.
  • Provide managers with details of board reviews to support staff efficiency and productivity.
  • Identify and help correct staff performance issues, including promotions, discipline, coaching, and termination recommendations.
  • Assist with hiring qualified candidates for open QA positions.
  • Ensure QA staff follow their duties, including physician follow-up, report review, delivery of completed reports, and adherence to client-specific instructions.
  • Participate in issue resolution with QA staff, physicians, account managers, and other relevant parties.
  • Ensure referrals meet client-directed turnaround time requirements.
  • Serve as the liaison between the reviewer, team member, and client regarding file status and process.
  • Perform other duties and special projects as assigned based on business needs.

Requirements

  • Associate’s degree or Bachelor’s degree preferred.
  • RN licensure required.
  • Medical peer review or healthcare industry knowledge required.
  • Business experience in a healthcare and/or insurance setting preferred.
  • Exceptional communication skills with a clear understanding of company business lines.
  • Ability to apply critical thinking, manage time efficiently, and meet specific deadlines.
  • Computer literacy and typing skills are essential.

Benefits

  • Medical, dental, and vision coverage for employees and their families.
  • Voluntary life insurance options for the employee, spouse, and children.
  • Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance.
  • Basic life insurance, short-term disability, and long-term disability coverage at no cost.
  • Generous paid time off.
  • 401(k) plan with company match.
  • Apple equipment and a media stipend provided for remote workspace.

Interested in this position?

Apply directly on the company website

Apply Now

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