New Jersey Licensed Quality Auditor

Job Summary

To support quality management initiatives, the full-time New Jersey Licensed Quality Auditor will conduct file audits for clinical operations, analyze compliance with regulatory standards, and manage documentation and reporting in a remote setting.

Key responsibilities

• Conduct quarterly and monthly file audits to assess compliance with NCQA, URAC, and CMS standards
• Analyze and distribute audit outcomes, including error trends, to Business Unit Directors for process improvement
• Serve as database administrator for CMS-CAPs results and facilitate MCG-IRR testing, ensuring adherence to regulatory compliance

Required qualifications

• Active Unrestricted NJ RN, LCSW, LMFT, LSW, or LPC License required
• Minimum of three (3) years clinical experience required
• Strongly prefers a minimum of three (3) years clinical quality or audit experience
• Bachelor's degree preferred
• Knowledge of audit methodologies and procedures preferred