North Carolina Licensed Clinical Auditor

Job Summary

A company is looking for a Clinical Quality Management Auditor.

Key Responsibilities

• Evaluate and monitor staff or provider performance for quality excellence
• Perform quality audits of member medical records to ensure compliance with HEDIS specifications
• Provide feedback and recommendations based on audit results and support clinical quality leadership in operational activities

Required Qualifications

• RN with 3 years of clinical experience or LPN with 5 years of clinical experience required
• Previous work experience in HEDIS, Medical Record Review, or quality programs
• Bachelor's degree or advanced degree preferred
• Knowledge of clinical quality improvement operations, including HEDIS, strongly preferred
• Experience in conducting patient chart reviews to obtain clinical measures is preferred