Job DetailsJob Location: Norwood, MA 02062Position Type: Full TimeSalary Range: $27.00 - $31.25 HourlyTravel Percentage: NoneReady for a Rewarding Career that Fits Your Lifestyle? Imagine a job where you can keep your clinical skills sharp, tackle exciting challenges, AND work from the comfort of your own home. Sounds like the perfect mix, right? MES is looking for a self-driven, high-performing Registered Nurse (RN) or Licensed Vocational Nurse (LVN) to join our dynamic team as a Clinical Quality Assurance Coordinator. In this role, you’ll ensure our Peer Review case reports are nothing short of exceptional—delivering top-notch quality and integrity, all while staying fully aligned with client agreements, regulatory standards, and state and federal mandates. The position is 100% remote with a schedule of Monday through Friday: three days: 12-8:30pm EST two days: 8-4:30 EST Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews. Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations. Ensures that all client instructions and specifications have been followed and that all questions have been addressed. Ensures 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. Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards. Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report. Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists. Ensures the provider credentials and signature are adhered to the final report. Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed. Assists in resolution of customer complaints and quality assurance issues as needed. Ensures all federal ERISA and/or state mandates are adhered to at all times. Provides 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. If you’re ready to make a real impact in healthcare, all while enjoying the flexibility of working remotely, we want to hear from you! Qualifications Active RN/LVN nursing license required. Must be a graduate of an accredited nursing program or related medical experience; bachelor's degree preferred. A minimum of two years clinical or related field experience; or equivalent combination of education and experience. Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values. Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages. Must be a qualified typist with a minimum of 40 W.P.M 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 possess excellent skills in English usage, grammar, punctuation and style. Ability to follow instructions and respond to upper managements’ directions accurately. Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed. Must be able to work independently, prioritize work activities and use time efficiently. Must be able to maintain confidentiality. MES Solutions is a premier provider of independent medical examination and peer review services to the insurance, corporate, legal, and government sectors. Members of our credentialed medical panel conduct physical examinations or medical record reviews, delivering reports that assist clients in the resolution of automotive, disability, liability, and workers' compensation claims. MES has been providing services nationally since 1978 in accordance with the industry's highest standards of operating excellence and regulatory compliance. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans MES offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Become a part of our caring community and help us put health first The Quality Improvement Senior Clinical Professional (RN) is responsible for the implementation and management oversight of the company's Medicare Stars Program in the Central FL/Orlando region. The Quality Improvement Senior Clinical Professional (RN) develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. The Quality Improvement Clinical Professional (RN), also known as Senior Stars Improvement, Clinical Professional (RN), represents the scope of health plan/provider relationships. This scope spans across the following areas. The Quality Improvement Clinical Professional (RN) will report to the Manager, Stars Improvement, Clinical. - Provider facing Zoom virtual/telephonic meetings - Quality/clinical management and population health - HEDIS and Stars performance - Operational improvements - Financial performance and incentive programs - Data sharing and connectivity - Documentation and coding - Additional areas related to provider performance, member experience, market growth, provider experience and operational excellence Required Qualifications - Licensed Registered Nurse (RN) without restriction in applicable state - 5+ years of clinical nursing experience - 1+ years' experience in a healthcare operational role, including hospital, provider or member facing nursing responsibilities - Experience in provider engagement and relationship management - Experience with Stars measures and quality improvement programs - Proven ability to influence clinical practice or provider performance - Comprehensive knowledge of Microsoft Office applications, Word and Excel with advanced knowledge of PowerPoint - Valid driver's license with reliable transportation and the ability to travel up to 30% within the region Preferred Qualifications - Bachelor's degree in nursing - 3+ years of managed care experience - 3+ years of case management experience - Knowledge of HEDIS/Stars/CMS Use your skills to make an impact Additional Information - Hours for the role are: Monday-Friday 8am-5pm EST - This role is currently remote/virtual with travel to provider offices within region up to 30% - This position will be located in the Central FL/Orlando region. Driving Statement This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. HireVue Statement: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round. Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. #LI-LM1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Sr CRA Midwest oncology ICON plc is a world-leading healthcare intelligence and clinical research organization. We’re proud to foster an inclusive environment driving innovation and excellence, and we welcome you to join us on our mission to shape the future of clinical development What You Will Be Doing: - Monitoring clinical trial sites to ensure adherence to study protocols, regulatory requirements, and Good Clinical Practice (GCP) standards. - Conducting site visits to assess site performance, resolve issues, and provide support to ensure successful trial execution. - Collaborating with cross-functional teams to ensure timely and accurate data collection and reporting. - Providing training and guidance to site staff and other CRAs to maintain high standards of clinical trial conduct. - Building and maintaining effective relationships with site personnel and stakeholders to facilitate smooth trial operations. Your Profile: - Advanced degree in a relevant field such as life sciences, nursing, or medicine. - Extensive experience as a Clinical Research Associate, with a strong understanding of clinical trial processes and regulatory requirements. - Proven ability to manage multiple sites and projects simultaneously, with strong organizational and problem-solving skills. - Expertise in monitoring practices, data integrity, and site management, with proficiency in relevant clinical trial software and tools. - Excellent communication, interpersonal, and stakeholder management skills, with the ability to influence and drive compliance within a complex environment. - Must be located in the MidWest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin) - Oncology monitoring experience is required - Ability to travel at least 60% of the time (international and domestic - fly and drive) and should possess a valid driver’s license - Ability to travel at least 60% of the time (international and domestic - fly and drive) and should possess a valid driver’s license What ICON can offer you: Our success depends on the quality of our people. That’s why we’ve made it a priority to build a diverse culture that rewards high performance and nurtures talent. In addition to your competitive salary, ICON offers a range of additional benefits. Our benefits are designed to be competitive within each country and are focused on well-being and work life balance opportunities for you and your family. Our benefits examples include: - Various annual leave entitlements - A range of health insurance offerings to suit you and your family’s needs. - Competitive retirement planning offerings to maximize savings and plan with confidence for the years ahead. - Global Employee Assistance Programme, TELUS Health, offering 24-hour access to a global network of over 80,000 independent specialised professionals who are there to support you and your family’s well-being. - Life assurance - Flexible country-specific optional benefits, including childcare vouchers, bike purchase schemes, discounted gym memberships, subsidised travel passes, health assessments, among others. Visit our careers site to read more about the benefits ICON offers. At ICON, inclusion & belonging are fundamental to our culture and values. We’re dedicated to providing an inclusive and accessible environment for all candidates. ICON is committed to providing a workplace free of discrimination and harassment. All qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please let us know or submit a request here. Interested in the role, but unsure if you meet all of the requirements? We would encourage you to apply regardless – there’s every chance you’re exactly what we’re looking for here at ICON whether it is for this or other roles. Are you a current ICON Employee? Please click here to apply

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This role requires the nurse to exercise clinical judgment and perform the following duties: - Review and interpret clinical documentation obtained from medical records or systems. - Apply clinical decision-making to utilize appropriate clinical criteria and policies for post-service claims - Coordinate clinical resolutions independently, with clinician/MD support as required - Act as a resource for customer service and claims processing teams - Train new staff and provide cross-training to existing team members - Identify trends and provide feedback to leadership if discrepancies or potential fraudulent activities are identified - Remain current with applicable laws, regulations, and internal workflows to ensure full compliance with organizational and state-specific requirements Required Qualifications: - Nursing degree (RN) - A minimum of 2–3 years of professional experience as a licensed Registered Nurse (RN), or equivalent clinical experience - Strong analytical skills to assess medical claims Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $29.10 - $62.32 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/26/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.