Quality Analyst (Remote, LPN Required)

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Quality Analyst (Remote, LPN Required) in the United States.

The Quality Analyst plays a critical role in ensuring that medical services are delivered efficiently, appropriately, and in line with regulatory standards. This position involves reviewing patient records, evaluating treatment plans, and collaborating with healthcare providers to optimize care quality. The role requires applying clinical knowledge and critical thinking to determine the necessity of procedures, ensuring compliance with evidence-based guidelines, and supporting continuous process improvements. Working remotely, you will interact with cross-functional teams to maintain high standards of care, provide clinical oversight, and contribute to operational excellence. This position combines patient-centered decision-making with data-driven evaluation to impact both healthcare outcomes and organizational success.

Accountabilities

·        Review medical records, treatment plans, and patient information to assess the medical necessity and appropriateness of services.

·        Apply established guidelines (e.g., CMS, Milliman Care Guidelines, InterQual) to validate treatments and ensure regulatory compliance.

·        Serve as a clinical reference for non-clinical staff and provide expert guidance to management teams and physicians.

·        Input and manage essential clinical data within medical management platforms accurately and efficiently.

·        Identify opportunities for process improvements to enhance turnaround time, reduce errors, and increase client satisfaction.

·        Oversee and mentor team members, providing quality assurance and ensuring consistency in case reviews.

·        Communicate effectively with stakeholders, including physicians, management teams, and the Medical Director, to support optimal patient care.

Requirements

·        Active and unrestricted LPN/LVN license from an accredited vocational nursing program (or RN degree from an accredited college).

·        Minimum of 2 years clinical nursing experience and at least 1 year in Utilization Management or related field.

·        Strong communication skills, both written and verbal, with the ability to maintain professional interactions with healthcare providers and clients.

·        Excellent organizational skills, attention to detail, and ability to manage multiple priorities in a dynamic environment.

·        Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.

·        Ability to apply clinical reasoning and evidence-based guidelines to complex cases.

·        Capability to work independently in a remote environment with reliable internet access and home workspace setup.

Benefits

·        Competitive compensation: $45,000 - $70,000 USD, based on experience and qualifications.

·        Comprehensive medical, dental, and vision coverage for employees and their families.

·        Voluntary life insurance options for employee, spouse, and children.

·        Additional voluntary benefits: hospital indemnity, critical illness, accident, and pet insurance.

·        Basic life insurance, short-term disability, and long-term disability coverage at no cost.

·        Generous paid time off policy.

·        401(k) retirement plan with company match.

·        Remote work equipment provided, including Apple devices and media stipend.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching. When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.

🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the 3 candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.

The process is transparent, skills-based, and free of bias—focusing solely on your fit for the role. Once the shortlist is completed, it is shared directly with the company. The final decision and next steps (such as interviews or additional assessments) are made by their internal hiring team.

Thank you for your interest!

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