Opportunity Description
Review medical records to identify potential quality, safety, and utilization concerns
Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations
Support peer review processes and quality improvement initiatives
Analyze trends and assist in identifying patterns in care delivery and outcomes
Collaborate with clinical leadership, including Medical Directors, to review findings
Participate in quality committees and performance improvement efforts
Ensure compliance with regulatory requirements and program standards
Coordinate with cross-functional teams such as case management, care coordination, and program integrity
What you must have:
Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW)
Minimum 3+ years of clinical e...
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