Quality Assurance Analyst – UM Nurse, MD
My client, a reputable healthcare company, is hiring for a Remote Quality Assurance Analyst and is looking for UM Nursing experience. Job Description:
- Their process includes the following:
- Double Checking to verify what was processed. Were certain surgeons and specialties used? Was State Insurance used? Were these correct?
- Identifying if what was asked by the clients met in their visits? Nothing more or less. If they were supposed to get a certain service, verify it was met up to the T.
- Did these services meet their policies and criteria? Was the service necessary and required?
- This person will take the answers to these questions, and then provide the answers and updates to their client.
- They will make sure that the report being sent over is written up well, grammatically correct, and double check that the clinical information and explanation makes sense.
- They will be providing phone call and email communication to their clients about these results.
- They may have some quick turnaround cases, so time management is going to be important.
- Going through the appeals and reviewing all types of Prior Authorizations.
- Will be doing Admissions reviews using InterQual
- Chemotherapy and Radiation Treatment reviews
- Outpatient test and procedure authorizations
Qualifications to Apply:
- A Nursing Degree either RN ($31.50/hour) or LPN ($29/hour) and everything active
- Utilization Management experience would be a big help here.
- Great communication both written and phone
- Clinical knowledge to do the reviews
- Any previous remote work is a plus
- Must have a compact license that can suffice in all 50 states
APPLY NOW!!!! Job Type & Location This is a Contract to Hire position based out of Rockville, MD 20852. Pay and Benefits The pay range for this position is $29.00 - $31.25/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Dec 4, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. Apply tot his job Apply To this Job