Clinical Quality Reviewer - REMOTE - LCSW OR RN - US Citizen Required

Compensation: $85,000 – $92,000 Hourly Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically 1st shift) CLIENT NOTES / EXPECTATIONSClient anticipatesmultiple hires (approx. 5 roles) Requestingtop 7 qualified candidates for initial interview slate Candidates must meetrequired AND preferred qualifications Speed is critical? need strong pipeline immediately Target topresent candidates early next week Internal recruiter support will be assigned on client side ? PRIORITY DEADLINESubmit top 7 candidates by: EOD Monday (12/30/26) APPROVED WORK STATES (RECRUITING GUIDELINES)AK, AR, AZ, CO, DC, FL, HI, IA, ID, 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 OR LCSW Minimum 3+ years clinical experience (med/surg and/or behavioral health) Strong clinical documentation + writing ability Must be eligible for DoD background clearance PREFERRED QUALIFICATIONS (HIGHLY DESIRED)Clinical Quality / Utilization Review / Case Review experience Experience with federal or government healthcare programs InterQual or similar clinical criteria tools Data analysis / reporting exposure Bachelor's degree in Nursing or healthcare-related field CORE RESPONSIBILITIES (WHAT THEY ACTUALLY DO)Review medical records for quality, safety, and utilization issues Identify Potential Quality Issues (PQIs) Support peer review + quality improvement initiatives Collaborate with Medical Directors Analyze trends and recommend improvements Ensure compliance with regulatory and program standards IDEAL CANDIDATE PROFILEExperience with health plans or large healthcare systems#J-18808-Ljbffr