Clinical Quality Assurance Coordinator (RN/LPN Required)

Make an Impact on Healthcare Quality

Are you a detail-oriented Registered Nurse (RN) or Licensed Practical Nurse (LPN) with a passion for quality, compliance, and clinical excellence? We are seeking a Clinical Quality Assurance Coordinator to join our growing team and play a vital role in ensuring the accuracy, integrity, and compliance of clinical peer review reports.

This position is ideal for a nursing professional who enjoys analyzing clinical documentation, collaborating with medical professionals, and helping maintain the highest standards of healthcare quality.

What You'll Do

As a Clinical Quality Assurance Coordinator, you will be responsible for reviewing clinical reports and ensuring compliance with client requirements, regulatory standards, and company quality expectations.

Key Responsibilities

• Perform comprehensive quality assurance reviews of peer review reports, correspondence, addendums, and supplemental reviews.
• Verify that all recommendations and determinations are supported by clear, concise, evidence-based clinical rationale.
• Ensure client instructions, specifications, and case questions have been fully addressed.
• Review clinical citations and references for accuracy, relevance, and currency.
• Ensure reports maintain the highest standards of professionalism, quality, formatting, and presentation.
• Verify appropriate physician specialty reviews are completed in accordance with client requirements and state mandates.
• Confirm reviewer attestations, provider credentials, signatures, and conflict-of-interest requirements are properly documented.
• Identify report inconsistencies and collaborate with peer reviewers to obtain clarifications, corrections, or modifications.
• Support the resolution of client concerns and quality assurance issues.
• Ensure adherence to federal ERISA regulations, state mandates, and internal compliance standards.
• Provide feedback to leadership regarding consultant quality, compliance, and availability.
• Participate in training, educational opportunities, and quality improvement initiatives.
• Assist with additional projects and duties as assigned.

Required Qualifications

Must Have

• Current, active RN or LPN license required
• Strong clinical knowledge and understanding of medical terminology and healthcare documentation
• Exceptional attention to detail and analytical skills
• Ability to work independently and manage priorities effectively
• Strong written and verbal communication skills
• Reliable, organized, and self-motivated professional

Preferred Qualifications

• CPC (Certified Professional Coder) certification
• Medical coding or healthcare documentation review experience
• Prior quality assurance, utilization review, peer review, case management, or clinical compliance experience
• Knowledge of ERISA, regulatory compliance, and healthcare quality standards

Key Skills

• Clinical Quality Assurance
• Medical Record Review
• Healthcare Compliance
• CPC Coding
• Clinical Documentation Review
• Quality Improvement
• Regulatory Compliance
• Utilization Review
• Case Review
• Medical Terminology
• Attention to Detail
• Independent Decision-Making

Why Join Us?

✅ Utilize your nursing expertise in a non-bedside role

✅ Work with a collaborative and mission-driven healthcare team

✅ Gain exposure to quality assurance and clinical compliance processes

✅ Build valuable experience in peer review and healthcare quality management

✅ Opportunity for professional growth and development

Experience Level: Entry-Level to Early Career

Required License: Active RN or LPN License

This is a Contract to Hire position based out of Rockford, IL.

The pay range for this position is $26.50 - $28.50/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan –