New Jersey Licensed Quality Auditor
Job Summary
Conducting quality audits for state audits and HEDIS, the part-time New Jersey Licensed Quality Auditor will manage on-site and virtual reviews, prepare reports, and assist in training staff while working remotely on a contract basis.
Key responsibilities
- Conduct on-site/virtual reviews to assess compliance with documentation standards and quality of medical records
- Prepare documentation summarizing findings and provide education to physicians on opportunities for improvement
- Assist the Quality Management department with special projects and manage the Corrective Action Plan (CAP) process
Required qualifications
- Three to five years of related business experience, preferably in the healthcare industry
- Active New Jersey Registered Nurse License or License Practical Nurse License
- Valid Motor Vehicle driver's license and access to an automobile
- Knowledge of managed care principles and medical terminology
- Familiarity with URAC accreditation standards and HEDIS principles preferred
Complete Job Description
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