Dane Street is hiring a
Clinical Quality Analyst

Summary

The Clinical Quality Analyst at Dane Street reviews physician reports, communicates with customers, physicians, and internal employees, and ensures clinical content accuracy. They should have an Associate's Degree or Bachelor's Degree, business experience in a healthcare and/or insurance setting, and be an Active Registered Nurse (preferred). The job offers a comprehensive benefits package.

Requirements

• An Associate’s Degree or Bachelor’s Degree is preferred
• Business experience in a healthcare and/or insurance setting is preferred
• Active Registered Nurse (preferred)
• Disability experience is required

Responsibilities

• Review each physician report for data accuracy including spelling, grammar & punctuation
• Ensure that all state requirements for reporting are met
• Responsible for report format and adhering to each client’s specific requirements
• Ensure that all client special handling instructions with regard to report completion and delivery are met
• Timely delivery of the final report
• Escalate any occurrence, per referral, that falls outside of previously established customer, company, or departmental requirements to the appropriate entity
• Communicate with reviewers, customers, and internal employees, verbally and via email, professionally in compliance with all established formats and policies
• Perform an independent analysis of a claimant’s medical records for our clients when requested
• Serve as an additional level of QA for cases with Quality Issues
• Work directly with physicians to ensure that all client questions are answered and supported by clinical rationale
• Conduct regular follow-up with the physician or their office staff to ensure on-time delivery of the report
• Compose and provide verbal or written feedback to the doctor regarding report quality
• Compose and provide verbal or written requests to the physician or their office staff for clarifications
• Receive written or verbal confirmation from the physician that a report has the doctor’s approval and that the doctor provides his/her signature for the final report
• Provide regular report status updates to the client
• Evaluate the Quality of the physician’s report and determine if the report will meet all client and jurisdictional standards; the QA Specialist is also responsible for ensuring that the clinical rationale supports the physician’s determinations
• Clarify ambiguous report questions with clients
• Follow up with the client for any missing information that is pertinent to the referral

Benefits

• Health insurance
• Retirement benefits
• Performance bonuses