Job Description

JOB SUMMARY

About Us: Dane Street is dedicated to improving wellness for all employees by fostering a positive working environment that promotes client satisfaction and results. Our success relies on the contributions of both individuals and teams every day. We care for our customers, each other, and Dane Street.

Position Overview: The Clinical Quality Analyst plays an integral role in the review process, responsible for communicating with customers, reviewers, and management to ensure timely delivery of completed reports by the customer's requested due date. In addition to performing the duties of a Quality Analyst, the Clinical Quality Analyst ensures the accuracy and adequacy of clinical content and serves as a resource for non-medically trained QAs.

MAJOR DUTIES & RESPONSIBILITIES

Board Management:

• Manage all referrals assigned to a reviewer within the designated division.
• Review assigned referrals daily to ensure completion or escalation of customer-specific tasks per process.
• Ensure completion or escalation of company-specific best practices on all referrals daily, per process.
• Ensure timely delivery of the final report.

Communication:

• Communicate with reviewers, customers, and internal employees professionally via email and verbally, adhering to all established formats and policies.

Clinical Duties:

• Perform independent analysis of a claimant’s medical records (“Nurse Review”) for clients when requested.
• Serve as an additional level of QA for cases with quality issues.

Qualifications:

• Medical background or relevant clinical experience.
• Strong attention to detail and accuracy in reviewing clinical content.
• Excellent verbal and written communication skills.
• Ability to work collaboratively in a team-oriented environment.
• Strong organizational and time management skills.

Why Dane Street?

• We value individual and team contributions that drive our success.
• We prioritize maintaining a positive and supportive work environment.
• We are committed to client satisfaction and delivering quality results.

If you are passionate about clinical quality and enjoy working in a collaborative and dynamic environment, we encourage you to apply for the Clinical Quality Analyst position at Dane Street.

Requirements

EDUCATION/CREDENTIALS:

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

JOB RELEVANT EXPERIENCE:

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

JOB RELATED SKILLS/COMPETENCIES:

• Active Registered Nurse

• Disability experience is required

Qualifications:

• Medical background or relevant clinical experience.
• Strong attention to detail and accuracy in reviewing clinical content.
• Excellent verbal and written communication skills.
• Ability to work collaboratively in a team-oriented environment.
• Strong organizational and time management skills.

WORKING CONDITIONS/PHYSICAL DEMANDS:

Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work.

WORK FROM HOME TECHNICAL REQUIREMENTS:

Supply and support their own internet services. 

Maintaining an uninterrupted internet connection is a requirement of all work from home position.

We provide a monthly stipend for internet resources.

This job description is subject to change at any time.

Our Commitment:

We are committed to providing fair and competitive compensation that reflects each employee's contributions and performance. We value diversity and strive to create an inclusive environment for all employees.

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.

Job Tags

Similar Jobs