RN Clinical Validation Audit Manager

Job Summary

A company is looking for a Clinical Validation Audit Manager.

Key Responsibilities

• Foster a positive work environment that promotes employee engagement and professional growth
• Track and evaluate Key Performance Indicators (KPIs) to ensure auditors meet productivity benchmarks
• Identify opportunities for process improvements and support the implementation of strategies that enhance recovery outcomes

Required Qualifications, Training, and Education

• Current unrestricted nursing license, RN, RHIT, CCS, CIC, or CPC preferred
• 5+ years of experience in Payment Integrity Complex Audit & Recovery programs
• Expertise in complex reimbursement methodologies, including MS-DRG and APR DRG experience
• Experience managing a remote team of audit professionals
• Strong organizational, project management, and analytical skills