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, provide mentorship, and collaborate with clinical leadership to enhance compliance and operational improvements.
Key responsibilities
- Conduct comprehensive clinical compliance audits and monitor adherence to regulatory and contractual requirements
- Analyze audit results to identify trends and opportunities for operational and compliance improvement
- Provide mentorship and subject matter expertise to Clinical Compliance Auditors and clinical operations staff
Required qualifications
- Active, unrestricted Registered Nurse (RN) license
- 3-5 years of experience in utilization management, clinical auditing, or clinical compliance
- Strong knowledge of utilization management processes and regulatory compliance requirements
- Familiarity with Medicare, Commercial Managed Care, and delegated services compliance
- Proficiency with Microsoft Office, including Excel and reporting tools
Complete Job Description
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