Dane StreetDS

Group Health QA Supervisor - RN

Dane Street’s sole mission is to provide objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports using our national panel of physicians and delivered with our signature personalized service.

Dane Street

Employee count: 201-500

United States only

The QA Supervisor is responsible for the oversight of the review of Physician reports and accompanying medical records to ensure that the report is complete, accurate, and consistent with medical evidence.

Oversight of QA staff

  • Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team.
  • Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file.
  • Provide details of board reviews to managers to ensure efficiency and productivity of staff.
  • Assist in identifying correcting staff performance including promotions, discipline, coaching and termination of staff.
  • Assist in hiring qualified candidates for QA open positions.

Ensure that all QA staff adhere to and meet their specific job duties including but not limited to:

    • Following up with Physicians for outstanding reports
    • Reviewing received reports for accuracy
    • Delivering completed reports back to all applicable parties
    • Following all client-specific instructions
  • Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other related parties.
  • Ensure referrals meet the client-directed Turn Around Time (TAT).
  • Act as the liaison between the reviewer, team member and client regarding the process or status of the file.
  • Other duties special projects, as assigned and based on business needs.

Requirements

EDUCATION/CREDENTIALS:

An Associate’s Degree or Bachelor’s Degree is preferred.

RN licensure required

JOB RELEVANT EXPERIENCE:

Medical peer review or healthcare industry knowledge required.

Business experience in a healthcare and/or insurance setting is preferred.

JOB RELATED SKILLS/COMPETENCIES:

Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.

Benefits

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

About the job

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Job type

Full Time

Experience level

Mid-level
Manager

Location requirements

Hiring timezones

United States +/- 0 hours

About Dane Street

Learn more about Dane Street and their company culture.

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Dane Street’s sole mission is to provide objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports using our national panel of physicians and delivered with our signature personalized service. Dane Street provides Independent Medical Exams (IMEs), Peer Reviews, and other medical review reports for both the commercial and government sectors. We have over 16,000 physicians servicing 25,000 locations covering 100 specialties including expertise with Workers' Compensation, Auto, Liability, Disability, Group Health, and Federal/State claims.

Dane Street stands out in the Independent Medical Exam and Review market due to our commitment to quality, fast turnaround times, and efficient processes. Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities all count on Dane Street to support their claims and clinical teams in making accurate determinations through our expert medical analyses. With a dedicated team that has years of industry experience, Dane Street consistently meets our client’s highest expectations with services that are delivered with our signature personalized service.

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Dane Street

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Dane Street hiring Group Health QA Supervisor - RN • Remote (Work from Home) | Himalayas