Florida Licensed Clinical Auditor

Job Summary

Providing support for healthcare services clinical auditing activities, the full-time Florida Licensed Clinical Auditor will perform audits across various clinical functional areas to ensure compliance with regulatory requirements and quality member outcomes.

Key responsibilities

• Conducts audits in utilization management, care management, and behavioral health to monitor compliance with regulatory guidelines
• Reports monthly outcomes, identifies training needs for clinical staff, and communicates findings to leadership
• Maintains detailed records of auditing results and assists in developing training materials based on audit findings

Required qualifications

• At least 2 years of healthcare experience, including 1 year in utilization management or care management
• Active Registered Nurse (RN) license in the state of practice
• Strong analytical skills and attention to detail
• Ability to work collaboratively in a cross-functional environment
• Proficiency in Microsoft Office and relevant software applications