Registered Nurse Clinical Compliance Auditor

Job Summary

To ensure adherence to regulatory requirements and internal standards, the full-time Remote Registered Nurse Clinical Compliance Auditor will conduct comprehensive audits, monitor compliance, and provide mentorship within clinical operations.

Key responsibilities

• Conducting clinical compliance audits focused on utilization management and regulatory adherence
• Monitoring compliance with Managed Services Agreements and client-specific requirements
• Providing mentorship and guidance to Clinical Compliance Auditors and clinical operations staff

Required qualifications

• Active, unrestricted Registered Nurse (RN) license
• 3-5 years of experience in utilization management or clinical auditing
• 2 years of clinical compliance auditing or healthcare auditing experience
• Strong knowledge of utilization management processes and regulatory compliance
• Proficiency with Microsoft Office, including Excel and reporting tools