Job Overview: TEEMA is looking for a skilled Registered Nurse to join our remote Quality Review team. In this full-time position, you will play a crucial role in evaluating healthcare services, ensuring compliance with quality standards, and improving patient outcomes through detailed clinical reviews. Working remotely from anywhere, you will collaborate with healthcare providers to uphold excellence in care delivery without the need for on-site presence. Key Responsibilities: Conduct thorough reviews of patient records, clinical documentation, and treatment plans to assess adherence to regulatory guidelines and best practices. Identify areas for improvement in care quality, risk management, and operational efficiency, providing actionable recommendations to healthcare teams. Perform audits on utilization management, case reviews, and peer reviews, ensuring accuracy and consistency in clinical decision-making. Collaborate with interdisciplinary teams via virtual platforms to discuss findings, resolve discrepancies, and implement quality improvement initiatives. Maintain detailed reports and documentation of all reviews, contributing to data-driven insights for organizational performance. Stay updated on industry standards, such as those from CMS, NCQA, and state regulations, applying them to daily reviews. Required Qualifications: Active Registered Nurse (RN) license in good standing, with at least 3-5 years of clinical nursing experience in acute care, long-term care, or managed care settings. Bachelor's degree in Nursing (BSN) preferred; Associate Degree in Nursing (ADN) with relevant experience considered. Proficiency in electronic health records (EHR) systems and quality review software. Strong knowledge of healthcare regulations, including Medicare/Medicaid guidelines, HEDIS measures, and URAC standards. Excellent computer skills for remote work, including secure virtual communication tools like Zoom or Microsoft Teams. Skills: Exceptional attention to detail and analytical thinking for identifying patterns in complex clinical data. Superior written and verbal communication skills to articulate review findings clearly and professionally. Ability to work independently in a remote environment while meeting strict deadlines and productivity targets. Proficiency in medical terminology, coding (ICD-10, CPT), and clinical guidelines. Strong ethical judgment and commitment to patient privacy under HIPAA regulations. Adaptability to evolving healthcare policies and technology. Company Info: TEEMA is a leading staffing and solutions provider in healthcare, technology, and other industries, committed to connecting top talent with innovative opportunities. With a focus on flexibility and employee success, we support remote professionals nationwide, fostering a collaborative culture that values work-life balance and professional growth. Benefits: Competitive salary based on experience, comprehensive health, dental, and vision insurance, 401(k) with company match, generous paid time off, and remote work stipend for home office setup. Additional perks include professional development reimbursement, wellness programs, and employee assistance services. Growth Opportunities: Advance your career with ongoing training in quality assurance, leadership development programs, and pathways to senior review roles or utilization management positions. TEEMA offers mentorship, certifications support (e.g., CPQH, CPHQ), and exposure to diverse healthcare projects for long-term career progression.