Quality Analyst (Remote, LPN Required) at Blank Street

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs); Licensed Practical/Vocational Nurse with an active and unrestricted license to practice (LPN required)
Minimum 2 years clinical nursing experience
Minimum 1 year of previous experience in Utilization Management
Proficient in both written and spoken communication; capable of maintaining professional communication with physicians and clients
Skilled at handling multiple tasks and adjusting swiftly in a dynamic setting
Keen organizational sense and close attention to details
Adept at resolving intricate and multifaceted problems
Experienced with Microsoft tools such as Word, Excel, PowerPoint, Outlook, Access, and Windows; proficient understanding of computer operations, particularly the Internet
Background in medical or clinical practice through education, training, or professional engagement
Capability to acquire new skills and competencies to address evolving requirements of systems, software, and hardware
Supply and support own internet services for remote work

Responsibilities

Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria), ensuring medical necessity of treatments
Examine and evaluate patient records to verify the quality of patient care and the necessity of provided services
Offer clinical expertise and serve as a clinical reference for non-clinical staff members
Input and manage essential clinical details within various medical management platforms
Keep up-to-date with regulatory prerequisites (such as URAC) and state standards for utilization review
Apply clinical reasoning to determine suitable evidence-based guidelines
Foster efficient and high-quality patient care by effectively communicating with management teams, physicians, and the Medical Director
May provide oversight to the work of team members
Continuously improves processes to facilitate better turnaround time, peer-to-peer success rates, and lessen returned reports by clients for clarification, resulting in higher client satisfaction
Responsible for the final approval on cases for release to the client
Act as a liaison and coordinate quality issue reports along with all new reviewer reports with the VP of Clinical Operations

Skills

Key technologies and capabilities for this role

Utilization ReviewMedical Necessity AssessmentCMS GuidelinesMilliman Care GuidelinesInterQualURACClinical ReasoningPatient Records ReviewCare Coordination

Questions & Answers

Common questions about this position

Is this Quality Analyst position remote?

Yes, the position is fully remote.

What nursing license is required for this role?

An unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs) is required.

What key skills are needed for the Utilization Management Nurse Reviewer role?

The role requires proficient written and spoken communication, ability to multitask in a dynamic setting, strong organizational skills with attention to detail, problem-solving abilities, Microsoft Office proficiency, and a background in medical or clinical practice.

What are the main responsibilities of this position?

Responsibilities include conducting assessments of medical services for appropriateness, evaluating patient records, providing clinical expertise, managing data in platforms, staying updated on regulations, applying clinical reasoning, and communicating with teams, physicians, and the Medical Director.

What makes a strong candidate for this Quality Analyst role?

Strong candidates have an active LVN/RN license, clinical background, excellent communication and multitasking skills, proficiency in Microsoft tools, and experience with medical necessity reviews using guidelines like CMS or InterQual.

Blank Street

Specialty coffee shop with efficient service

About Blank Street

Blank Street provides a unique coffee shop experience by offering high-quality coffee and food at affordable prices. The company started with a small coffee cart in Brooklyn and has since expanded to major cities like New York, London, Boston, and Washington, D.C. Their product offerings include specialty coffees sourced from around the world and fresh, locally-sourced food. Customers can enjoy a quick yet premium experience, thanks to the efficiency of their small locations that help keep costs down. Blank Street differentiates itself from competitors by focusing on customer convenience through technology, such as their app that allows for ordering ahead, customizing drinks, and participating in loyalty programs. They also prioritize employee satisfaction by paying baristas above-market wages. The goal of Blank Street is to redefine the coffee shop experience by combining quality, affordability, and exceptional service, making it a significant player in the specialty coffee market.

New York City, New YorkHeadquarters

2020Year Founded

$50.6MTotal Funding

EARLY_VCCompany Stage

Food & Agriculture, Consumer SoftwareIndustries

201-500Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Paid Vacation

Paid Sick Leave

Paid Holidays

Parental Leave

Flexible Work Hours

Company Equity

Risks

Rapid expansion may lead to operational inefficiencies and overextension.

Subscription program may not resonate with all customer segments, risking dissatisfaction.

Reliance on outsourced vendors poses risks if supply chain disruptions occur.

Differentiation

Automated espresso machines ensure consistent quality and enhance barista-customer interaction.

Small, cost-effective locations reduce overhead and allow competitive pricing.

Focus on high-quality, clean, and natural products at affordable prices.

Upsides

Rapid expansion into major cities increases brand visibility and market presence.

Subscription model provides steady revenue and enhances customer loyalty.

Partnerships with lifestyle brands boost brand visibility and customer engagement.

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