Registered Nurse Clinical Compliance Auditor
Job Summary
To ensure adherence to regulatory requirements and internal clinical standards, the full-time Registered Nurse Clinical Compliance Auditor will conduct comprehensive audits, monitor compliance activities, and provide mentorship in a remote work environment.
Key responsibilities
- Conduct comprehensive clinical compliance audits and monitor adherence to regulatory standards and contracts
- Analyze audit results to identify trends and opportunities for operational and compliance improvements
- Provide mentorship and guidance to Clinical Compliance Auditors and clinical operations staff
Required qualifications
- Active, unrestricted Registered Nurse (RN) license
- Strong knowledge of utilization management processes and regulatory compliance requirements
- Minimum of 3-5 years of experience in utilization management, clinical auditing, or clinical compliance
- Knowledge of Medicare and Commercial Managed Care compliance requirements
- Proficiency with Microsoft Office, including Excel and reporting tools
Complete Job Description
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