Remote Clinical Utilization Management Auditor

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Thu, Nov 11, 2021

This job expires in: 10 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A senior healthcare company has an open position for a Remote Clinical Utilization Management Auditor.

Individual must be able to fulfill the following responsibilities:

  • Develop and conduct audits as assigned
  • Prepare summary of audit findings with appropriate notification to management of issues
  • Examine and compare records and processes with required standards for accuracy

Applicants must meet the following qualifications:

  • An unrestricted RN or LVN/LPN license (desired) Bachelor’s degree
  • A minimum of 4 years within Medical Management at a Health Plan
  • Understanding of CMS guidelines and MA requirements
  • Ability to comfortably multi- task: you’ll be listening, talking and typing all at the same time
  • Ability to work in a startup, fast paced environment

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