RN Auditor - New Mexico

Job Summary

RN Auditor - New Mexico, this full-time position involves conducting clinical audits to ensure compliance with regulatory requirements and quality standards in healthcare services.

Key Responsibilities

• Perform audits in various clinical areas and monitor compliance with guidelines
• Assess clinical staff decision-making and report outcomes to leadership
• Maintain detailed records of auditing results and assist in developing training materials

Required Qualifications

• At least 2 years of healthcare experience, including 1 year in utilization management or care management
• Active Registered Nurse (RN) license in the state of practice
• Experience in clinical review/auditing of care management is preferred
• Familiarity with NCQA auditing standards is advantageous
• Proficiency in Microsoft Office and applicable software programs