Performs quality review oversight visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as ...
Performs quality review oversight visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as ...
Performs quality review oversight visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as ...
Performs quality review oversight visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as ...
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 ...
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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 ...
Reporting to the Manager of Provider Quality Oversight, the Provider Quality Review Nurse, RN is responsible for: * Receive and research all PQI and QR cases as assigned, provide a summary and ...
Reporting to the Manager of Provider Quality Oversight, the Provider Quality Review Nurse, RN is responsible for: * Receive and research all PQI and QR cases as assigned, provide a summary and ...
RN Quality Review
Mexia, TX · On-site
RN - Quality Review Join Parkview Regional Hospital in Mexia, TX, a 49-bed, acute-care facility providing services that include medical/surgical care, rehabilitation, and emergency care. Parkview ...
RN Quality Review
Mexia, TX · On-site
RN - Quality Review Join Parkview Regional Hospital in Mexia, TX, a 49-bed, acute-care facility providing services that include medical/surgical care, rehabilitation, and emergency care. Parkview ...
HEDIS Review Nurse - Remote - Contract
Dallas, TX · Remote
$42/hr
The review nurse is responsible for medical record abstractions and overreads during the annual ... Perform quality reviews of abstracted medical records as assigned * Ensure open and honest ...
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HEDIS Review Nurse - Remote - Contract
Dallas, TX · Remote
$42/hr
The review nurse is responsible for medical record abstractions and overreads during the annual ... Perform quality reviews of abstracted medical records as assigned * Ensure open and honest ...
RN Quality Review
Mexia, TX · On-site
Job Summary The RN - Quality Review is responsible for supporting the organization's quality and patient safety initiatives through data collection, analysis, and process improvement activities. This ...
RN Quality Review
Mexia, TX · On-site
Job Summary The RN - Quality Review is responsible for supporting the organization's quality and patient safety initiatives through data collection, analysis, and process improvement activities. This ...
Utilization Review Nurse
Las Vegas, NV · On-site
Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in ... This role works closely with clinical teams to ensure efficient resource utilization and quality ...
Utilization Review Nurse
Las Vegas, NV · On-site
Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in ... This role works closely with clinical teams to ensure efficient resource utilization and quality ...
Utilization Review Nurse
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Participate in quality improvement initiatives and utilization management committees.Stay current ...
Utilization Review Nurse
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Participate in quality improvement initiatives and utilization management committees.Stay current ...
Concurrent Review Nurse
Miami, FL · On-site
Concurrent Review Nurse Under the general supervision of the Director of Health Services, the ... Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ...
Concurrent Review Nurse
Miami, FL · On-site
Concurrent Review Nurse Under the general supervision of the Director of Health Services, the ... Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ...
Utilization Review Nurse
$30 - $40/hr
RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is ... for Quality Assurance (NCQA) standards. Responsibilities: * Prepare case reviews for Medical ...
Utilization Review Nurse
$30 - $40/hr
RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is ... for Quality Assurance (NCQA) standards. Responsibilities: * Prepare case reviews for Medical ...
Quality Review Coordinator
Birmingham, AL · On-site
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... nursing degree program or experience required to obtain Registration (RN) from the state. The ...
Quality Review Coordinator
Birmingham, AL · On-site
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... nursing degree program or experience required to obtain Registration (RN) from the state. The ...
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... nursing degree program or experience required to obtain Registration (RN) from the state. The ...
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... nursing degree program or experience required to obtain Registration (RN) from the state. The ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Ensures medically appropriate, high quality, cost effective care through assessing the medical ...
REMOTE RN - Quality Review
Phoenix, AZ · Remote
$42 - $43.50/hr
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 ...
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REMOTE RN - Quality Review
Phoenix, AZ · Remote
$42 - $43.50/hr
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 ...
Utilization Review Nurse
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for ... for Quality Assurance (NCQA) standards. Responsibilities * Prepare case reviews for Medical ...
Utilization Review Nurse
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for ... for Quality Assurance (NCQA) standards. Responsibilities * Prepare case reviews for Medical ...
Concurrent Review Nurse
Miami, FL · On-site
Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...
Concurrent Review Nurse
Miami, FL · On-site
Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...
Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...
Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...
Quality Review Nurse information
See salary details
$29.5K - $42.3K
2% of jobs
$42.3K - $55K
0% of jobs
$66.3K is the 25th percentile. Wages below this are outliers.
$55K - $67.8K
26% of jobs
The median wage is $76.8K / yr.
$67.8K - $80.6K
31% of jobs
$80.6K - $93.4K
11% of jobs
$98K is the 75th percentile. Wages above this are outliers.
$93.4K - $106.1K
11% of jobs
$106.1K - $118.9K
5% of jobs
$118.9K - $131.7K
7% of jobs
$131.7K - $144.5K
2% of jobs
$144.5K - $157.2K
1% of jobs
$157.2K - $170K
2% of jobs
$29.5K
$90.3K
$170K
How much do quality review nurse jobs pay per year?
What is a quality review nurse?
A Quality Review Nurse is responsible for evaluating patient care to ensure it meets clinical standards, regulatory requirements, and organizational policies. They review medical records, analyze data, and identify areas for improvement to enhance healthcare quality and patient safety. These professionals often collaborate with healthcare teams to develop best practices, ensure compliance, and recommend corrective actions when needed. Their role is essential in maintaining high standards of care and improving overall healthcare outcomes.
What does a quality review nurse do?
A typical day for a Quality Review Nurse involves reviewing patient medical records to ensure compliance with healthcare regulations and organizational quality standards, identifying areas of improvement, and documenting findings for reporting. You will often collaborate with clinical staff, quality assurance teams, and management to recommend process improvements and provide feedback on care delivery practices. Quality Review Nurses may also participate in case reviews, audits, and staff training, making the work both analytical and interactive. This role requires balancing independent record analysis with teamwork to drive effective quality initiatives throughout the healthcare facility.
What are the key skills and qualifications needed to thrive as a quality review nurse?
To thrive as a Quality Review Nurse, you need a solid clinical background in nursing, critical thinking skills, and strong attention to detail, typically supported by an active RN license and several years of nursing experience. Familiarity with quality assurance protocols, electronic health records (EHR) systems, and healthcare accreditation standards (such as The Joint Commission) is commonly required. Excellent communication, problem-solving abilities, and a collaborative mindset help distinguish top performers in this role. These skills are crucial for ensuring compliance, promoting patient safety, and driving continuous improvement in healthcare quality standards.
What cities are hiring for Quality Review Nurse jobs?
Cities with the most Quality Review Nurse job openings:
What are the most commonly searched types of Quality Review Nurse jobs?
The most popular types of Quality Review Nurse jobs are:
What states have the most Quality Review Nurse jobs?
States with the most job openings for Quality Review Nurse jobs include:
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The top searched job categories for Quality Review Nurse jobs are:

QUALITY REVIEW NURSE SPECIALIST
Indianapolis, IN • On-site
Full-time
Posted 13 days ago
Job description
Health and Hospital Corporation is an organization that celebrates diversity, and seeks to employ a diverse workforce. We actively encourage all individuals to apply for employment and to seek advancement opportunities. Health and Hospital Corporation also provides reasonable accommodations to qualified individuals with disabilities as required by law. For additional questions please contact us at: hrmail@hhcorp.org.
Assists the Vice President of Long Term Care and other department personnel in the review and analysis of care and services provided by HHC owned nursing homes and licensed residential facilities. Performs on site and office review of various clinical resident care services and nursing management operations at the long term care facilities and prepares related reports for the long term care department, individual facilities and the contract management company. Assists in the analysis of various aspects of nursing home operations using professional standards of practice and industry benchmarks and in the preparation of reports for the HHC Board of Directors' Planning Committee. This position is responsible for promoting health and wellbeing of long term care residents of Health and Hospital Corporation Marion County nursing facilities by promoting preventive, therapeutic, and supportive care based on standards of practice and in compliance with all applicable regulatory requirements.
Responsibility 1: 70%
- Performs quality review oversight visits to HHC owned nursing homes and retirement communities as assigned. May serve as a member of a quality review team or at times may visit assigned facilities as the sole representative from the HHC Long Term Care Department. Maintains a professional and supportive role when interacting with the nursing home and licensed residential facility staff providing helpful observations and suggestions.
- Performs various auditing/review activities during the site visits including but not limited to: medication administration observations, wound care and treatment administration, personal care services, meal service, clinical record reviews and review of nursing management records. At times may assist the other members of the quality review team to complete their assigned tasks. Other review tasks may include: resident or family interviews, review of quality assurance records, in-service training records, personnel files, incident report logs, professional facility consultant reports and other records as assigned. Must be knowledgeable and mindful of potential liability and other risk management issues and methods for taking appropriate preventative or corrective action.
- Participates in the exit conferences held with facility management and the quality reviewers and provides summary information regarding significant observations during the facility visit including specific resident and employee identification when possible. When requested, participates in taking notes at the exit conference for exit conference reports.
- Prepares a written site visit report following each facility visit in cooperation with other quality review team members who participated in the facility visit. Reviews report for accuracy, and clarity. Distributes reports in a confidential manner to all parties and maintains HHC records.
- Assures the retention and confidentiality of all data materials from facility visits and forwards to the department Executive Assistant for proper storage/retention.
Responsibility 2: 30%
- Participates in the compilation and completion of quarterly and other reports prepared for the HHC Board of Directors' Planning Committee.
- May attend HHC Planning Committee meetings as assigned to represent the Long Term Care Department or to present a special report.
- Assists in the completion and follow up of any requests or directives resulting form the Planning Committee meetings as assigned.
- Accepts phone calls from residents, family members and interested parties in the absence of other Long Term Care Department staff or as assigned. Receives concerns or information in a manner that reflects good customer service practices and prepares detailed written information for the Vice President's review and processing.
- Attends community and professional association functions and meetings representing HHC Long Term Care division as requested.
- Participates in the development of educational materials and staff training programs relative to long term care.
- Assists in development of departmental policies, procedures and forms for use in the departmental functions.
- In the absence of the Executive Assistant, makes travel arrangements/reservations for department staff conducting out of town facility site visits.
- Must be able to communicate effectively in verbal and written communications and able to adhere to deadlines and interruptions and frequent assignment changes, etc. Must have good customer service skills for interacting with facility residents and personnel on site visits as well as the general public.
- Graduate of an approved school of nursing (diploma, associate or B.S. degree).
- Access to own vehicle and current automobile insurance.
- 5 - 10 years of previous experience in long term care in a nursing management role.
- Knowledge of local/State/Federal laws and regulations applicable to state licensure of nursing homes and residential nursing facilities, federal regulations for skilled nursing homes and participation in Medicare and Medicaid programs, communicable disease control, and other applicable long term care requirements.
- Licensed Registered Nurse (Indiana).
- Valid Indiana Driver's license.
- Unconfined sitting 75%
- Confined sitting 15%
- Standing or walking 10%
- Steady use of hands or fingers - Typing and filing 85%
- Lift, carry, etc. with arms and legs - Carrying small boxes to meetings 15%
- Ability to perform driving functions in normal course of work day with confined sitting for several hours at times.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
About HHC
Sourced by ZipRecruiter
Industry
Software development
Company size
1 - 10 Employees
Headquarters location
Fairfax, VA, US
Year founded
2001