Clinical QA Supervisor

Company: Dane Street

Location: United States

Dane Street is a fast-paced, Inc. 500 Company with a high-performance culture, seeking insightful professionals. We process over 200,000 insurance claims annually and provide customized Independent Medical Exams and Peer Review programs.

About the Role

The Clinical QA Supervisor is responsible for overseeing the review of Physician reports and accompanying medical records to ensure completeness, accuracy, and consistency with medical evidence. This role involves supervising QA staff and managing the File Review Board.

Oversight of QA Staff

• Ensure appropriate QA staff are assigned to each file.
• Supervise assigned staff and manage the File Review Board for timely and accurate file processing.
• Provide details of board reviews to managers to ensure efficiency and productivity.
• Assist in identifying and correcting staff performance issues (promotions, discipline, coaching, termination).
• Assist in hiring qualified candidates for QA open positions.

QA Staff Responsibilities

Ensure all QA staff adhere to job duties, including:

• Following up with Physicians for outstanding reports.
• Reviewing received reports for accuracy.
• Delivering completed reports to all applicable parties.
• Following all client-specific instructions.
• Actively participating in issue resolution.
• Ensuring referrals meet client-directed Turn Around Time (TAT).
• Acting as the liaison between reviewers, team members, and clients.
• Performing other duties and special projects as assigned.

Education/Credentials

• Associate’s Degree or Bachelor’s Degree preferred.
• RN licensure required.

Job Relevant Experience

• Medical peer review or healthcare industry knowledge required.
• Business experience in a healthcare and/or insurance setting preferred.

Job Related Skills/Competencies

• Exceptional communication skills.
• Critical thinking and time management skills.
• Ability to meet specific deadlines.
• Computer literacy and typing skills.

Benefits

• Medical, dental, and vision coverage for you and your family.
• Voluntary life insurance options.
• Other voluntary benefits: hospital indemnity, critical illness, accident indemnity, pet insurance.
• Basic life insurance, short-term disability, and long-term disability coverage at no cost.
• Generous paid time off policy.
• 401k plan with a company match.
• Apple equipment and a media stipend for remote workspace.