QA Clinical Nurse Reviewer

Description

Company Overview:

For over 30 years, The IMA Group has been dedicated to enhancing the livelihood and productivity of individuals and organizations navigating challenging periods of health, work and disability while actively contributing to the development of new medical treatments and clinical advancements. At IMA, we are not just a company; we are a community committed to making a difference.

Job Summary:

The IMA Group is seeking a QA Clinical Nurse Reviewer who plays a critical role in ensuring the quality and accuracy of clinical records, case reports, and treatment plans. This position combines clinical expertise with analytical skills to improve documentation, accuracy of information, and overall patient outcomes. The role involves communicating with case managers and other departments to facilitate high-quality care while optimizing costs and resources.

This position is not considering candidates from New York City, Chicago, California, Colorado, or Washington states at this time.

Responsibilities:

• Conduct QA audits to ensure accurate documentation, including treatment plans, Return to Work (RTW), Maximum Medical Improvement (MMI), and compliance with company policies and procedures.
• Utilize clinical judgment to assess case needs, monitor treatment plans, and recommend care optimization or alternative approaches as necessary.
• Evaluate and analyze data from QA audits to identify process improvements and report findings/recommendations to the National Operations Director to enhance care coordination and drive improvements.
• Conduct clinical reviews of case manager reports to ensure clear objectives, appropriate treatment plans, and support optimal outcomes and quality preservation.
• Handle and prioritize multiple tasks and projects efficiently in a time-sensitive manner while collaborating with other departments to meet company goals and performance targets.
• Utilize data analysis tools to identify patterns, trends, and opportunities for enhancing the quality of care and cost-efficiency.
  
  

Qualifications:

Required-

• Current unrestricted RN license
• Bachelor of Science Degree in Nursing or higher
• 5+ years of experience in workers’ compensation
• 5+ years of acute care clinical experience
• Familiarity with workers’ compensation terminology
• Proficiency in medical terminology
• Proficiency in MS Word, Excel, PowerPoint, Outlook, and Microsoft Teams
  
  

Preferred-

• 2+ years of experience conducting QA audits
• 2+ years of experience in case management
  
  

Benefits:

• Complete Health Coverage: Comprehensive Health, Dental, and Vision Insurance packages to ensure your well-being.
• Balanced Lifestyle: Generous paid time off, holidays, and a floating holiday to maintain a healthy work-life balance.
• Retirement: A 401k plan with employer matching for a secure financial future.
• Comprehensive Benefit Offerings: Benefits include LTD, STD, Flexible Spending Account, Voluntary Life, Voluntary ADD, and Company-paid Life Insurance and ADD coverage.
• Tuition Assistance and Student Loan Repayment Assistance: Benefit from IMA’s tax free tuition reimbursement and tax-free student loan repayment assistance program to fuel your ongoing educational journey and to help you pay for the degree you already have!
• Family Support: Paid maternity leave and paid parental leave reflecting our commitment to supporting families.
• No on Call Responsibilities: When you are home, you can leave work behind.
  
  

The IMA Group is an Affirmative Action/Equal Opportunity Employer

Our Government Services Division supports local, state, and federal agencies and delivers professional and objective medical and psychological examinations as well as ancillary services. Our Payer Services Division meets the evaluation and screening needs of Carriers, TPAs, Public Entities and Employers and includes behavioral health and physical medicine specialty services, working with a wide range of organizations within the workers' compensation, disability, liability, and auto markets. Our Clinical Research Division performs all types of Phase II-IV clinical trials in multiple therapeutic areas through a flexible nationwide network of site locations and virtual capabilities.