Senior Quality Assurance Professional - Remote

Overview

The Senior Quality Assurance Clinical Professional will assist in developing policies and procedures to ensure operational quality and compliance standards are met, supporting high-quality standards in clinical products and services.

In Short

• Assist with development of quality assurance policies and procedures.
• Support and implement programs for high-quality clinical standards.
• Collaborate with management for quality improvement.
• Conduct audits and summarize compliance reports.
• Analyze data trends for operational readiness.
• Ensure compliance with DMAS, NCQA, and CMS guidelines.
• Work independently and communicate with leadership.
• May require occasional travel for meetings or audits.
• Use Microsoft Office for reporting and communication.
• Participate in a hybrid work model with remote capabilities.

Requirements

• Active Registered Nurse license in Virginia or multi-state license.
• Minimum 3 years clinical experience in acute or rehabilitation settings.
• Experience in care management nursing.
• Knowledge of Medicaid and Medicare.
• Quality assurance and compliance auditing experience.
• Exceptional communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office applications.
• Bachelor’s degree in nursing preferred.
• Experience with DMAS, CMS, HEDIS, and NCQA preferred.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability benefits.
• Life insurance and other opportunities.