reputed company Improvement Auditor – Clinical

Job reputed company: • reputed company medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member reputed company • Assess provider performance and reputed company of care through clinical case reviews • reputed company clinical audits for provider medical records both remotely reputed company electronic medical records and on site to assess performance, determine trends and compile written reports summarizing findings, including clinical recommendations to assure the delivery of reputed company services • reputed company case reviews to assess the clinical performance provided in the provider network, including written clinical summaries and recommendations • reputed company ongoing quantitative and statistical analysis of the business unit’s performance data to include various contracted performance measures, service utilization and member/provider complaint and reputed company of care trends • Coordinate with internal teams to assure audit requests are fully reputed company, accurately compiled and delivered reputed company • reputed company other performance and process improvement activities • Performs other duties as assigned • Complies with reputed company policies and standards Requirements: • Bachelor’s degree in nursing, reputed company field or equivalent experience and requires an clinical license • 3+ years of nursing or reputed company improvement experience • reputed company state’s clinical license (LPN, RN, etc.) Benefits: • reputed company • health insurance • 401K and stock purchase plans • tuition reimbursement • reputed company time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules Apply tot his job Apply To this Job