Role Description
The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates. This position is required to handle quality assurance questions and provide support to the Quality Assurance Department.
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Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
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Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
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Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
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Ensure each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
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Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
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Ensure the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates and is documented accurately on the case report.
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Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
Qualifications
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Must be an RN or LPN to be considered.
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Background in healthcare quality, compliance, or utilization review is beneficial.
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Experience working with peer reviewers or clinical consultants in a quality assurance or review capacity.
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Familiarity with ERISA and state regulatory mandates related to clinical reviews and documentation.
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Strong communication skills to interact with reviewers, internal teams, and other stakeholders when clarifications or corrections are needed.
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Comfort working in a contract-to-hire arrangement with potential for long-term engagement.
Requirements
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This is a Contract to Hire position based out of Chicago, IL.
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The pay range for this position is $26.50 - $31.00/hr.
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Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
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Eligibility requirements apply to some benefits and may depend on your job classification and length of employment.
Benefits
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Medical, dental & vision
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Critical Illness, Accident, and Hospital
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401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
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Life Insurance (Voluntary Life & AD&D for the employee and dependents)
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Short and long-term disability
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Health Spending Account (HSA)
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Transportation benefits
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Employee Assistance Program
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Time Off/Leave (PTO, Vacation or Sick Leave)
Application Deadline
This position is anticipated to close on Oct 31, 2026.
Workplace Type
This is a fully remote position.