Utilization Review Nurse- $26.50-$28.50/hr

Job Title: Clinical Quality Assurance Nurse / Utilization Review Nurse - 100% Remote

Pay: see below

• Registered Nurse - $28.50/hr (Non-negotiable)
• LPN/LVN- $26.50/hr (non-negotiable)

Regular Schedule after training:

• Flexible Monday -Friday between (7am-8:30pm EST)

Position Overview: Responsible for ensuring case reports are of the highest quality and integrity and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates. This position is required to handle quality assurance questions and provide support to the Quality Assurance Department.

ESSENTIAL JOB FUNCTIONS

- Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.

- Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.

- Ensure that all client instructions and specifications have been followed and that all questions have been addressed.

- Ensure each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from

reputable medical journals and/or publications.

- Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.

- Ensure the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates and is documented accurately on

the case report.

- Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.

- Ensure the provider credentials and signature are adhered to the final report.

- Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.

- Assist in resolution of client complaints and quality assurance issues as needed.

- Ensure all federal ERISA and state mandates are adhered to at all times.

- Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client

specifications.

- Promote effective and efficient utilization of company resources.

- Participate in various educational and or training activities as required.

- Perform other duties as assigned.

QUALIFICATIONS

- Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.

- Must be a qualified typist with a minimum of 40 W.P.M

- Must have a full understanding of HIPAA regulations and compliance.

- Must be able to operate a general computer, fax, copier, scanner, and telephone.

- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.

- Must demonstrate exceptional communication skills.

- Ability to follow instructions and respond to upper managements directions accurately.

- Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met.

- Must be able to work independently, prioritize work activities and use time efficiently.

- Must be able to maintain confidentiality.

- Must be able to demonstrate and promote a positive team -oriented environment.

- Must be able to stay focused and concentrate under normal or heavy distractions.

- Must be able to work well under pressure and or stressful conditions.

- Must possess the ability to manage change, delays, or unexpected events appropriately.

- Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.

This is a Contract to Hire position based out of Raleigh, NC.

The pay range for this position is $26.50 - $28.50/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

This is a Contract to Hire position based out of Raleigh, NC.

This position is anticipated to close on Oct 20, 2026.

This is a fully remote position.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.