Clinical Quality Review Nurse

Since our establishment in 2008, TEEMA has been at the forefront of revolutionizing the staffing industry. We take immense pride in serving over 1,200 clients spanning Canada, the United States, and international markets, specializing in delivering comprehensive staffing solutions. Our offerings, ranging from contract and temporary placements to payroll, permanent, and executive staffing, cater to various verticals, including Information Technology, Engineering, and Healthcare.

Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.

Review medical records to identify potential quality, safety, and utilization concerns Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations Support peer review processes and quality improvement initiatives Analyze trends and assist in identifying patterns in care delivery and outcomes Collaborate with clinical leadership, including Medical Directors, to review findings Participate in quality committees and performance improvement efforts Ensure compliance with regulatory requirements and program standards Coordinate with cross-functional teams such as case management, care coordination, and program integrity