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Clinical Quality Reviewer Jobs (NOW HIRING)

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

Madison, WI · 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 ...

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 ...

Americare

Pediatric Quality Reviewer

Brooklyn, NY · On-site

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

Americare

Pediatric Quality Reviewer

New York, NY · On-site

Pediatrics 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 100% Full Time. Highlights an 74% In-person, and 26% Remote job distribution.
RN Clinical Quality Reviewer

RN Clinical Quality Reviewer

TEEMA

Phoenix, AZ • Remote

$40 - $43/hr

Full-time

Posted 10 days ago

Job description

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 program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.
What you will be doing:

  • Review medical records to identify potential quality, safety, and utilization concerns

  • Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations

  • Support peer review processes and quality improvement initiatives

  • Analyze trends and assist in identifying patterns in care delivery and outcomes

  • Collaborate with clinical leadership, including Medical Directors, to review findings

  • Participate in quality committees and performance improvement efforts

  • Ensure compliance with regulatory requirements and program standards

  • Coordinate with cross-functional teams such as case management, care coordination, and program integrity


What you must have:

  • Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW)

  • Minimum 3+ years of clinical experience (medical/surgical and/or behavioral health)

  • U.S. Citizenship required

  • Ability to obtain and maintain a Department of Defense (DoD) background clearance

  • Strong analytical and critical thinking skills

  • Excellent written communication skills


Nice to have:

  • Bachelor’s degree in Nursing or healthcare-related field

  • Experience in clinical quality, utilization review, or case review

  • Familiarity with federal or government healthcare programs

  • Experience with clinical criteria tools (InterQual or similar)

  • Exposure to healthcare data analysis or reporting

Technical Skills

  • Proficiency with Microsoft Office (Word, Excel, Outlook)

  • Comfortable working across multiple systems and electronic medical records

What makes you successful

  • Strong clinical judgment and attention to detail

  • Ability to work independently and manage multiple priorities

  • Analytical mindset with problem-solving ability

  • Clear and professional communication skills

  • Comfortable working in a structured, compliance-driven environment


Other Information:

  • Remote or onsite depending on business needs

  • Must have a secure home office setup if remote

  • Occasional extended hours may be required

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About Teema

Sourced by ZipRecruiter

TEEMA is an award-winning, industry-leading recruitment agency dedicated to building meaningful relationships across North America. We achieve this time after time by consistently sourcing, screening, managing and securing top talent tailored to employers’ specific needs. The team that makes this happen consists of hundreds of experienced professional recruiters backed by exceptional, tenured leadership and back-office support. No matter how unique or challenging your hiring needs may be or how misunderstood or undervalued your in-demand skills may be in your current role, we have you covered. Our primary objective is to provide an exceptional recruitment experience for our clients and candidates and an ecosystem that empowers our team to thrive.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Litchfield Park, AZ, US

Social media

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