Clinical Quality Reviewer

Job Title: Clinical Quality Reviewer
Location: 100% Remote (US Only)
Compensation: $65,000-$75,000 + Full Benefits Package
Reports to: CMO

The Clinical Quality Reviewer plays a pivotal role in ensuring the clinical accuracy, compliance, and claim-readiness of documentation generated by Telemedica’s provider network. This role combines healthcare quality standards with specialized knowledge of VA disability claims to ensure veterans receive medical evidence that supports the integrity and efficacy of their claims. As Telemedica continues its transformation into a care delivery-focused organization with expanded patient care services, this role will expand to support quality oversight across a growing portfolio of clinical services.

What you will do (Immediate):

• Review completed DBQs, Nexus Letters, IMOs and other medical evidence documentation to ensure compliance with organizational and standard of care and clinical documentation standards

• Validate medical logic, completeness of supporting rationale, adherence to tone and content guidelines, and correct grammatical or clerical errors

• Return documents for provider revision when necessary and ensure re-submission meets final quality expectations

• Manage the clinical help desk system that facilitates provider corrections and clarification requests; escalate complex or unresolved clinical concerns to the Chief Medical Officer (CMO) or PLLC leads as needed

• Track turnaround times and report quality trends or provider-specific issues

• Provide clinical-specific education and re-education to providers on documentation standards, ensuring alignment with quality expectations and regulatory guidelines

What you will do (Long-Term):

• Build out standardized checklists and QA workflows for internal scalability

• Serve as a clinical knowledge resource for cross-functional teams

• Help develop provider training based on recurring QA trends

• Stay current with VA disability claim requirements and emerging standards for clinical documentation

What you will bring:

• Strong Communicator: Able to convey complex information clearly and empathetically to patients, providers, and internal teams.

• Flexible and Adaptable: Comfortable navigating evolving workflows, shifting priorities, and supporting transitional responsibilities during organizational change.

• Collaborative: Works effectively across clinical, administrative, and operational teams to ensure seamless service delivery.

• Innovative Problem Solver: Takes initiative to streamline processes, improve veteran experience, and adapt to challenges with a solution-oriented mindset.

• Detail-Oriented: Maintains accuracy in scheduling, documentation, and intake processes to support timely, high-quality care.

Required Qualifications:

• A valid and active license as a Registered Nurse (RN) or other relevant clinical license is essential

• 3+ years in a clinical documentation, chart review, or quality assurance role

• Strong written communication and editing skills with the ability to interpret medical terminology

• Deep understanding of the VA disability claims process and evidentiary requirements

• Experience with CRM, EHR, or care management platforms

Preferred Qualifications:

• Experience working with providers and clinical documentation systems

• Familiarity with quality standards in telehealth or virtual care environments

• Comfortable with clinical education and consistently applies clinical guidelines to ensure quality and compliance in documentation

Compensation and Benefits:

• Healthcare: PPO and HSA plans

• Retirement: 401(k) with up to 3% employer match

• Flexible Spending: Health Savings Account (HSA) and Flexible Spending Accounts (FSA)

• Paid Time Off: 30 Days Paid Time Off (PTO), plus 12 paid holidays, including Christmas closure

• Insurance: Short and Long-Term Disability, Life Insurance

• Family & Medical Leave: Paid Parental Leave, Military Leave, and Bereavement Leave

• Other Benefits: Employee discounts, Jury Duty Pay, Time-Off to Vote, and more

This position is NOT APPLICABLE to residents of: Alabama, California, Colorado, Kentucky, Montana, New York, North Dakota, Ohio, Oregon, Washington, Wyoming.

Telemedica is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, marital status, disability or any other basis prohibited by law.