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Clinical Quality Reviewer Jobs (NOW HIRING)

Memorial Hermann

Clinical Quality Reviewer

Plaza, ND · On-site

Job Summary The Clinical Quality Reviewer is responsible to collect and submit reliable data to the indicated registries and/or databases. This position assures appropriate data collection ...

TEEMA

RN Clinical Quality Reviewer

Phoenix, AZ · Remote

$40 - $43/hr

Job Summary RN Clinical Quality Reviewer TEEMA Full-time Remote | Phoenix, AZ, United States Overview: We are partnering with a leading organization supporting a large-scale federal healthcare ...

Onos

Clinical Quality Reviewer - BCBA

San Francisco, CA · On-site

$110K - $140K/yr

Clinical Quality Reviewer - BCBA About Onos Health Onos Health's mission is simple but ambitious: ensure every healthcare dollar goes toward delivering the highest quality care. Today, nearly 30% of ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to ...

Imedica

Supervisor, Clinical Quality Review

Omaha, NE · Remote

... standards, reviewer training, and tool readiness * Ensures SOPs and job aids are audit ready ... Demonstrated experience managing clinical review, quality, or audit work under strict regulatory ...

Americare

RN Quality Reviewer

New York, NY · On-site

Quality Reviewer RN Schedule:Monday - Friday 8:30 AM - 5:00 PM The Quality Reviewer is a Registered ... Strong clinical documentation skills. * Familiarity with CMS billing regulations. * Excellent ...

TEEMA Group

REMOTE RN - Quality Review

Phoenix, AZ · Remote

$42 - $43.50/hr

TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying ...

Americare

RN Quality Reviewer

Brooklyn, NY · On-site

Quality Reviewer RN Schedule: Monday - Friday 8:30 AM - 5:00 PM The Quality Reviewer is a ... Strong clinical documentation skills. * Familiarity with CMS billing regulations. * Excellent ...

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Clinical Quality Reviewer information

What are some common challenges faced by Clinical Quality Reviewers and how can they be addressed?

Clinical Quality Reviewers often encounter challenges such as interpreting complex clinical documentation, staying updated with regulatory changes, and ensuring consistent application of quality standards across diverse cases. To address these, it's important to maintain strong communication with clinical staff, participate in ongoing training, and utilize up-to-date review tools and checklists. Collaborating closely with other reviewers and quality teams can also help in sharing best practices and resolving ambiguous cases efficiently.

What does a Clinical Quality Reviewer do?

A Clinical Quality Reviewer is responsible for evaluating clinical documentation, processes, and patient care activities to ensure they meet established quality standards and regulatory requirements. They review medical records, analyze compliance with protocols, and identify areas for improvement to enhance patient safety and care outcomes. Clinical Quality Reviewers often collaborate with healthcare teams to implement quality improvement initiatives and provide feedback or training as needed. Their work is essential for maintaining accreditation and ensuring continuous improvement in healthcare facilities.

What are the key skills and qualifications needed to thrive as a Clinical Quality Reviewer, and why are they important?

To thrive as a Clinical Quality Reviewer, you need a solid background in healthcare, clinical knowledge, and quality assurance, often supported by a nursing or allied health degree and relevant certifications. Familiarity with clinical documentation systems, quality measurement tools, and regulatory compliance standards is typically required. Attention to detail, analytical thinking, and effective communication are vital soft skills for this role. These skills ensure accurate reviews, uphold compliance, and drive improvements in patient care quality.
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Clinical Quality Reviewer jobs near you
Infographic showing various Clinical Quality Reviewer job openings in the United States as of June 2026, with employment types broken down into 95% Full Time, and 5% Contract. Highlights an 63% In-person, and 37% Remote job distribution.
Clinical Quality Reviewer

Clinical Quality Reviewer

Memorial Hermann Health System

Houston, TX • On-site

Full-time

Posted 27 days ago

Memorial Hermann Health System rating

7.7

Company rating: 7.7 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

160th of 872 rated healthcare providers

Job description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
The Clinical Quality Reviewer is responsible to collect and submit reliable data to the indicated registries and/or databases. This position assures appropriate data collection, abstraction, analysis and reporting of noted measures and communicates changes in definitions, methodology, and mandatory requirements. This position will support the quality and patient safety improvement efforts through data abstraction and inputting into the appropriate system.Job Description
Minimum Qualifications
Education: Bachelor of Science in nursing highly preferred or a combination of four (4) years of training and experience
Licenses/Certifications:
  • Current State of Texas RN license to practice professional nursing
  • Non-RN practitioners must hold: Licensed vocational nurse or nurse practitioner (LVN/LPN) or Registered Health Administrator (RHIA) or Registered Health Information Technician (RHIT)

Experience / Knowledge / Skills:
  • Three (3) years of clinical experience to ensure knowledge base sufficient to support clinical performance improvement initiatives; Clinical chart review and abstraction experience a plus
  • Understanding of quality improvement, performance improvement or patient safety knowledge preferred
  • Ability to locate information in various sources to gather data in a complex hospital system environment
  • Clinical knowledge of assigned clinical conditions and physiological systems to discern the impact of specific indicators on outcomes and to identify potential gaps in clinical care processes
  • Ability to interact with all members of the healthcare team and administrative staff in a professional and courteous manner. Ability to build relationships and gain alignment for clinical support from superiors and peers
  • Demonstrated proficiency in computer operation, MS Office products (Word, Excel, PowerPoint)

Principal Accountabilities
  • Collects and submits data in a systematic way to all indicated registries and databases.
  • Identifies opportunities for performance improvement based on reliable data trending; recognizing and analyzing undesirable patterns or trends in performance.
  • Works in conjunction with hospital Quality Patient Safety and Infection Control teams to implement and revise the Performance Improvement Plan for designated campuses as needed.
  • Participates in performance improvement activities.
  • Maintains the requisite skills to complete analysis on data points that will drive performance improvement.
  • Attends meetings as needed to ensure reliable data collection of core measures.
  • Demonstrates applicability of the core measures methodology and the reliability of definitions utilized by reviewers through Inter-Rater Reliability (IRR) testing.
  • Effectively utilizes software applications for data collection and analysis.
  • Accountable for accurate and timely entry of data into the database and meeting caseload requirements.
  • Responsible for timely communication with clinical providers and stakeholders when gaps and/or fall-outs in clinical processes are identified.
  • Serves as an educational resource on the core measures methodology and algorithms for internal and external audiences by developing educational materials and delivering presentations.
  • Adheres to all Memorial Hermann policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
  • Demonstrates the ability to collaborate with others to achieve desired work results.
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
  • Other duties as assigned.

What Memorial Hermann Health System employees say

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About Memorial Hermann

Sourced by ZipRecruiter

The Memorial Hermann Southwest Hospital Women's Services is a magnet hospital as well as a level 3 designated facility with a blend of high-risk and community patients. This creates a fast-paced environment and a chance to work with a diverse population. Our Labor & Delivery unit has a low c-section rate and is extremely collaborative and close-knit. We have the ability to cross-train through all areas of Women's Services. We have a family-like atmosphere with an amazing amount of comradery, and our low turnover rates attest to this. Nurses here feel like they not only have autonomy but can also be advocates for their patients. MHSW not only prides ourselves on evidenced based practice, but nurses have a strong voice.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Houston, TX, US

Year founded

1907

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