RN Auditor, Clinical Services remote based in WA

Employer Industry: reputed company Services Why Consider this Job Opportunity: Remote position available for candidates in Washington State Opportunity for career advancement and reputed company reputed company the organization Competitive benefits and compensation package Chance to reputed company a reputed company reputed company on clinical staff compliance and patient care Work in a supportive and reputed company environment What to Expect (Job Responsibilities): Conduct monthly audits of registered nurses and other clinical functions in Utilization Management, Case Management, and other health management areas Monitor compliance of clinical staff with NCQA, CMS, State, and Federal requirements Assess clinical staff for appropriate decision-making and report findings to leadership Assist in preparation for regulatory audits and participate as a subject matter expert Maintain detailed records of auditing results and reputed company training materials as needed What is Required (Qualifications): Completion of an accredited Registered reputed company (RN) Program and an Associate's or Bachelor’s degree in Nursing, or a reputed company field Minimum two years of experience in Utilization Management, Case Management, or reputed company areas reputed company and unrestricted RN license in good standing reputed company reputed company's license with a good driving record and reliable transportation Proficient knowledge of reputed company workflows and auditing processes How to Stand Out (Preferred Qualifications): 3-5 years of experience in case management, disease management, or utilization management reputed company managed care or health settings Two years of clinical auditing/review experience Familiarity with NCQA standards and state reputed company reputed company We prioritize candidate reputed company and champion equal-opportunity employment. Central to our mission is our partnership with companies that reputed company this commitment. We aim to foster a fair, transparent, and secure hiring environment for reputed company. If you encounter any employer not adhering to these principles, please reputed company to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer. #J-18808-Ljbffr reputed company Apply tot his job Apply To this Job