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*Quality Management Nurse Consultant

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*Quality Management Nurse Consultant

  • Location:


  • Sector:

    MRS Medical

  • Job type:

    Temporary & Contract

  • Salary:


  • Contact:

    Dominique John Parole

  • Contact email:

  • Job ref:


  • Published:

    28 days ago

  • Expiry date:


HIRING!! Awesome Job Opportunity as a Quality Management Nurse Consultant for CVS Health

We, at Medical Recruitment Strategies is looking for the best Quality Management Nurse Consultant for CVS Health

Job Title: Quality Management Nurse Consultant

Job Period: March 20, 2023 - June 17, 2023

Job Location: Remote/Work from Home

Shift: Monday-Friday 8AM - 5PM

Pay Rate: $33.78/HR

As a Quality Management Nurse Consultant, your key responsibilities would include but are not limited to:

  • Responsible for the review and evaluation of clinical information and documentation.
  • Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
  • Independently coordinates the clinical resolution with internal/external clinician support as required.
  • Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
  • Accurately applies review requirements to assure case is reviewed by a practitioner with clinical expertise for the issue at hand.
  • Commands a comprehensive knowledge of complex delegation arrangements, contracts, clinical criteria, benefit plan structure, regulatory requirements, company policy and other processes which are required to support the review of the clinical documentation/information.
  • Pro-actively and consistently applies the regulatory and accreditation standards to assure that activities are reviewed and processed within guidelines.
  • Condenses complex information into a clear and precise clinical picture while working independently.
  • Reports audit or clinical findings to appropriate staff or others in order to ensure appropriate outcome and/or follow-up for improvement as indicated.

Experience / Qualification required:

  • Active and in good standing RN License in Pennsylvania
  • 10 years of RN clinical experience required- Managed Care, ER, UM, med-surg experience preferred

Please submit your most recent resume together with time of availability and updated contact number for a brief interview. Thank you!