RN Clinical Quality Auditor

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