Clinical Quality Reviewer - REMOTE - LCSW OR RN - US Citizen Required
TEEMA
phoenix, AZ(remote)
Compensation: $85,000 – $92,000
Hourly Equivalent: ~$41–$44/hr
Location: Remote
Schedule: Must work AZ hours (typically 1st shift)
CLIENT NOTES / EXPECTATIONS
Client anticipates multiple hires (approx. 5 roles)
Requesting top 7 qualified candidates for initial interview slate
Candidates must meet required AND preferred qualifications
Speed is critical ? need strong pipeline immediately
Target to present candidates early next week
Internal recruiter support will be assigned on client side
? PRIORITY DEADLINE
Submit top 7 candidates by:
EOD Monday (12/30/26)
APPROVED WORK STATES (RECRUITING GUIDELINES)
AK, AR, AZ, CO, DC, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TN, TX, UT, VA, WA, WI, WY
Only source candidates in these states
REQUIRED QUALIFICATIONS (MUST HAVE)
Active, unrestricted license:
RN OR LCSW
Minimum 3+ years clinical experience
(med/surg and/or behavioral health)Strong clinical documentation + writing ability
U.S. Citizenship required
Must be eligible for DoD background clearance
PREFERRED QUALIFICATIONS (HIGHLY DESIRED)
Clinical Quality / Utilization Review / Case Review experience
Experience with federal or government healthcare programs
InterQual or similar clinical criteria tools
Data analysis / reporting exposure
Bachelor’s degree in Nursing or healthcare-related field
CORE RESPONSIBILITIES (WHAT THEY ACTUALLY DO)
Review medical records for quality, safety, and utilization issues
Identify Potential Quality Issues (PQIs)
Write detailed case summaries + recommendations
Support peer review + quality improvement initiatives
Collaborate with Medical Directors
Analyze trends and recommend improvements
Ensure compliance with regulatory and program standards
IDEAL CANDIDATE PROFILE
Clinical reviewer / utilization review nurse
Experience with health plans or large healthcare systems
Strong analytical + writing skills