Oregon Licensed Clinical Auditor

Job Summary

A company is looking for a Clinical Audit Support Specialist to ensure the accuracy and compliance of Utilization Management processes.

Key Responsibilities

• Audit all aspects of the Utilization Management lifecycle for compliance and quality
• Identify systemic issues and recommend corrective actions across departments
• Compile detailed reports of audit findings and provide actionable recommendations

Required Qualifications

• 3-5 years of experience in Utilization Management and 1 year in an auditing role
• Nursing degree and a valid US-based nursing license (LVN/LPN or RN)
• Deep knowledge of NCDs, LCDs, MCG, and healthcare regulations
• Experience in developing reporting systems related to audit activities
• Preferred certifications include CHC or CPUR