Oklahoma Licensed Case Auditor

Job Summary

Ensuring compliance and quality in care management operations, the full-time Oklahoma Licensed Case Auditor will conduct comprehensive audits of case management activities and documentation while working remotely from Oklahoma.

Key responsibilities

• Conduct regular audits of care management records to ensure compliance with internal policies and regulatory standards
• Collaborate with care management leadership to address audit findings and implement corrective action plans
• Prepare audit reports and present findings to management, tracking performance metrics and compliance trends

Required qualifications

• High School diploma or GED required
• 2 - 4 years of related experience in auditing or case management
• Familiarity with NCQA, HEDIS, and healthcare regulatory requirements
• Experience with developing audit tools and tracking systems
• Vocational or technical education may be preferred