RN Clinical Quality Auditor

Job Summary

Working remotely, the Senior RN Clinical Quality Auditor will support care management products by reviewing processes for compliance, conducting audits, and collaborating on quality improvement initiatives.

Key responsibilities:

• Participate in audit preparation and review complex business processes to identify compliance risks and trends
• Monitor program staff for adherence to established policies and identify opportunities for process improvement
• Implement quality audits and provide coaching based on evaluation results to enhance program management

Required qualifications:

• Current, unrestricted RN license in state of residence
• 3+ years of proven experience in health plan quality improvement
• Demonstrated experience auditing clinical programs in a managed care setting
• Intermediate proficiency with Microsoft Word, Excel, and PowerPoint