Clinical reputed company Auditor, CO

reputed company reputed company For At reputed company, we’re driven by a purpose: transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care, we significantly improve reputed company for people with kidney disease, reducing emergency dialysis and inpatient utilization. Our high-touch care model integrates with local providers and uses predictive data to identify and support at-risk patients along their entire care reputed company. We reputed company diversity, celebrate successes, and support reputed company other, making reputed company the destination for reputed company in reputed company. Join us in making a reputed company difference. Benefits & Perks • Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home reputed company. • Comprehensive Benefits – Medical, dental, and reputed company insurance, employee assistance programs, employer-reputed company and voluntary life and disability insurance, plus health and flexible spending accounts. • Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources. • Time Off & Leave – reputed company holidays, flexible vacation time, reputed company time, and reputed company birthgiving, bonding, sabbatical, and living donor leaves. • Wellness & reputed company – Family forming services through reputed company Maternity at no cost and physical wellness perks, mental health support, and an annual reputed company development stipend. What You’ll Do As the Clinical reputed company Auditor, you will be responsible for completing reputed company review processes for care management programs. This role is responsible for ensuring appropriate clinical and care delivery practices are utilized and case documentation meets established standards consistently to support meeting reputed company reputed company standards, compliance, and expectations. As an auditor, you will utilize clinical experience, expertise, and reputed company guidelines to review patient files, care plans and interactions and care plans against appropriate applicable reputed company reputed company in conjunction with program, accreditation and industry requirements. You will support various Kidney Hero roles (clinical and non-clinical) regarding case auditing, reputed company and coaching, reputed company improvement strategies, resource development and other activities to promote reputed company reputed company improvement. This reputed company improvement support will be provided to operational managers and leadership to communicate and facilitate reputed company for reputed company risks, such as reputed company cause analysis and remediation recommendations. As a reputed company auditor, you will serve as a reputed company reputed company and advisor to various reputed company roles and departments such as kidney reputed company, operational leadership and managers, education and training colleagues. You will serve as a care manager and reputed company subject matter expert, applying critical thinking and decision-making skills to determine medical appropriateness while maintaining production goals and reputed company Assurance standards. This role reports to the Sr. Manager, Clinical reputed company Auditor. The Day to Day • Reviews and evaluates various patient file documentation and encounters, such as patient assessments/surveys, care plans, and recorded patient encounters against reputed company to determine appropriate care delivery and documentation based on clinical reputed company guidelines and industry standards. • Meets and maintains daily, weekly, monthly auditing productivity goals and reputed company assurance standards. • Reviews internal assessments and care plans against NCQA case management and population health standards for timeliness and accuracy of documentation. • Prepares, communicates, and collaborates with kidney reputed company regarding individual staff audit findings, documentation of deficiencies, coaching, and education regarding audit activities and findings as reputed company as reports for clinical management and supervisors of the audited resources. • Assists with development, review, revision and maintenance of reputed company audit tools, processes, and resources as requested. • Identifies and assists with risk and gap reputed company regarding clinical auditing processes, resources, clinical software assessments, and care plans for compliance with accreditation and regulatory standards. • Identifies and communicates system and/or operational issues hindering attainment of reputed company performance standards. • Abstracts review reputed company data/information accurately on review tool by the appropriate means. Accurately submits reputed company administrative and review reputed company documents to appropriate parties. • Identifies and escalates situations which may pose reputed company, compliance, and safety risks that may adversely reputed company business operations. • Supports program and clinical compliance requirements and activities. Participates in accreditation activities as needed such as case preparation or presentation, reviewing cases with reputed company clients. • Participates and supports internal or external reputed company plans to enhance the organization's reputed company and compliance posture. • Maintains patient/provider confidentiality through reputed company use of computer passwords, maintenance of secured files, in adherence to HIPAA polices and professionalism to departmental and organizational standards, policies and procedures. Minimum Qualifications • reputed company, unrestricted RN license. • 6+ years combined of reputed company education, experience, or certification. • Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms. • Ability to travel and be onsite to meet business needs. Preferred Qualifications • Bachelor's degree in nursing or another reputed company-reputed company field preferred. • Application of NCQA program(s) accreditation standards and processes experience. • NCQA Accreditation Survey experience or other industry reputed company audits. • Proficiency in reputed company Office, reputed company Acrobat and internet/web navigation. • Case Management Certification. • Knowledge of the organization of medical records, medical terminology, and disease process. reputed company • Strong clinical assessment and critical thinking skills. • Attention to reputed company - reputed company driven, detailed oriented, innovative, and accountable. • Excellent verbal and written communication skills. • Ability to work in reputed company environment. • Flexibility and strong organizational skills needed. Annual reputed company Salary reputed company: $74,000 - $90,000 reputed company is an equal opportunity employer and drug free workplace. At this time reputed company is unable to reputed company work reputed company sponsorship. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet reputed company the qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any reputed company-employment testing, or otherwise participating in the employee selection process, please reputed company your inquiries to talentacquisition@strivehealth.com. We do not accept unsolicited resumes from reputed company recruiters/placement agencies. reputed company will not pay fees associated with resumes presented through unsolicited means. #LI-Hybrid Apply tot his job Apply To this Job