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Clinical Quality Reviewer - REMOTE - LCSW OR RN
Remote / Online - Candidates ideally in
Phoenix, Maricopa County, Arizona, 85031, USA
Listed on 2026-10-26
Phoenix, Maricopa County, Arizona, 85031, USA
Listing for:
Lynn Rodens
Full Time, Remote/Work from Home
position Listed on 2026-10-26
Job specializations:
-
Nursing
RN Nurse
Job Description & How to Apply Below
Compensation: $85,000 – $92,000
Hourly Equivalent: ~$41–$44/hr
Location:
Remote
Schedule:
Must work AZ hours (typically 1st shift)
- Candidates must meet required AND preferred qualifications
AK, AR, AZ, CO, DC, FL, HI, IA, , IL, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TN, TX, UT, VA, WA, WI, WY
Only source candidates in these states
Required Qualifications (must Have)- Active, unrestricted license:
- RN
- Minimum 3+ years clinical experience (med/surg and/or behavioral health)
- Strong clinical documentation + writing ability
- U.S. Citizenship required
- Must be eligible for DoD background clearance
- Clinical Quality / Utilization Review / Case Review experience
- Experience with federal or government healthcare programs
- Inter Qual or similar clinical criteria tools
- Data analysis / reporting exposure
- Bachelor’s degree in Nursing or healthcare-related field
- Review medical records for quality, safety, and utilization issues
- Identify Potential Quality Issues (PQIs)
- Write detailed case summaries + recommendations
- Support peer review + quality improvement initiatives
- Collaborate with Medical Directors
- Analyze trends and recommend improvements
- Ensure compliance with regulatory and program standards
- Clinical reviewer / utilization review nurse
- Experience with health plans or large healthcare systems
- Experience in Med-Surg in a hospital environment
- Strong analytical + writing skills
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