A company is looking for a Clinical Quality Auditor, RN - Remote.
Key Responsibilities :
Review and audit contracted sub-delegates
Assist with report preparation and records regarding work function activities and projects
Support Medical Management Initiatives with quality improvement across various departments
Required Qualifications :
Current unrestricted RN license
5+ years of clinical experience
1+ years of experience in managed care or the insurance industry
Experience with Medicare and / or Medicaid
Knowledge of clinical standards of care, HEDIS, NCQA, and regulatory agency requirements
Quality Auditor • Grand Rapids, Michigan, United States