Careers

HQSI CareersCurrent Employment Opportunities

As a leader in healthcare quality improvement, we know our employees are crucial to our success, and we are committed to attracting and retaining dedicated, talented, and performance-driven professionals. We offer a dynamic, team-oriented work environment, competitive salaries and an excellent benefits program.

HQSI is an equal opportunity/affirmative action employer. It is the policy of HQSI to provide equal opportunity for all qualified persons and to not discriminate against any applicant for employment because of race, color, religion, national origin, sex, age, disability, veteran status, or any other status protected by state or local law.

Open Positions

 

NURSE REVIEW/Q.A. SPECIALIST

Online Application

 

Healthcare Quality Strategies, Inc. (HQSI) was founded in 1982, with the mission of accelerating healthcare quality improvement through a collaborative and interactive process, within the healthcare community. Headquartered in East Brunswick, NJ, we are a small, vibrant not-for-profit organization offering business solutions designed to make health care safer, more accessible, more efficient and more effective.

 

We are searching for a full time, office-based Nurse Review/QA Specialist (RN) in our Medical Review Services Department, and are proud to state that we are a URAC accredited IRO.

 

 Principle responsibilities include:

 

  • Performing medical necessity of admission and continued stay reviews including writing clinical summary and disseminating final determination letters to clients
  • Accessing and applying information from external resources to ensure and support sound evidence based clinical rationales
  • Performing quality assurance of medical reviews to ensure adherence to corporate standards and opportunities to improve efficiencies and quality
  • Developing and sustaining positive client relationships through client on-boarding, training, and management
  • Participating as subject matter expert in business development initiatives designed to build client base

 

Principle requirements (Knowledge,  Skills, and Education) include:

 

  • Active RN licensure in good standing
  • 3-5 years’ experience performing medical record review and/or abstraction (Utilization Review experience preferred)
  • Medical terminology; (familiarity with ICD-10, CPT and HCPCS preferred)
  • Clinical criteria software programs
  • Current standards of medical practice
  • Use and application of clinical screening criteria (i.e.,InterQual and MCG) within the last year (Certified Training in InterQual or MCG preferred)
  • Clinical Appeals and denials at all levels; 2+ years preferred
  • Quality improvement activities
  • Professional interpersonal skills; ability to interact with providers, physicians, consumers and peers
  • Solid analytical, assessment and communication skills (verbal and written)
  • Strong attention to detail
  • Computer proficiency, including Microsoft Office (Word, Excel, Outlook )
  • Organizational skills including effective time management, priority setting and process improvement
  • Ability to work independently and as a member of a team
  • Adapts to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations
  • Quality Improvement or Quality Assurance evaluations, recommendations and interventions

 

We offer a full suite of benefits including: Medical, Dental and Vision Plans, Short and Long Term Disability Plans, Life Insurance, FSA, HRA, Pension Plan, 401(k) Plan, a generous PTO program, and a collegial work environment.

 

We thank you for your interest in HQSI!

 

www.hqsi.org