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Utilization Management, Clinical QA Supervisor

4 hours, 50 minutes ago
United States
Full-time
Senior
QA Engineer
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 16

Description

  • Oversee review of physician reports and accompanying medical records for completeness, accuracy, and consistency with medical evidence.
  • Assign QA staff to files and coordinate file handling responsibilities across the team.
  • Supervise QA staff and manage the File Review Board to ensure timely and accurate file processing.
  • Provide board review details to managers to support staff efficiency and productivity.
  • Monitor staff performance and assist with coaching, promotion, discipline, and termination decisions.
  • Assist with hiring qualified candidates for open QA positions.
  • Ensure QA staff follow job duties, client-specific instructions, and required follow-up steps with physicians and parties.
  • Review completed reports for accuracy and ensure delivery to all applicable parties.
  • Work with QA staff, physicians, account managers, and other parties to resolve file-related issues.
  • Ensure referrals meet client-directed turnaround time requirements and act as liaison between reviewers, team members, and clients.

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 families.
  • Voluntary life insurance options for employee, spouse, and children.
  • Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance.
  • Company-paid basic life insurance, short-term disability, and long-term disability coverage.
  • Generous paid time off.
  • 401(k) plan with company match.
  • Apple equipment and a media stipend for the remote workspace.

Interested in this position?

Apply directly on the company website

Apply Now

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