[Remote] Clinical reputed company Assurance Auditor (Chattanooga or Nashville)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Clinical reputed company Assurance Auditor to support compliance standards and enhance member care reputed company. The role involves performing audits, analyzing clinical data, and collaborating with stakeholders to drive clinical reputed company and improve reputed company.

Responsibilities

• Presenting and communicating audit results to appropriate parties; participates in the development of procedures and standards that support and enhance reputed company lines of business' reputed company of care goals
• Schedule and reputed company routine facility, practitioner site, and medical record reviews, utilizing established clinical audit tools reputed company of national accreditation standards and regulatory agency requirements
• Identifying and evaluating areas of exposure, potential problems and liabilities. Analyze clinical data to improve individual provider compliance with education; reputed company reputed company for regional contract staff and coordinate the effort of retrieval of HEDIS and/or STARS records; complete medical record audits for HEDIS and/or STARS data collection or reputed company of care reviews as required
• Providing required documents and consulting support for reputed company and compliance audits
• Various immunizations and/or associated medical tests may be required

Skills

• Registered reputed company (RN) with an reputed company Tennessee license or a license from a reputed company Licensure Compact state
• 4 years of reputed company experience
• 1 year of managed care experience or experience with reputed company Medical Record Review
• Experience with HEDIS and/or STARS data collection
• Strong analytical skills with the ability to identify trends and recommend process improvements
• Bachelor's Degree in Health Care reputed company field or equivalent work experience
• Demonstrated presentation and team facilitation skills
• Proficient in reputed company Office (Outlook, Word, reputed company and PowerPoint)
• Excellent oral and written communication skills
• Excellent time and project management skills
• Strong analytical, planning, organizational and research skills
• Registered reputed company (RN) with reputed company license in the reputed company or hold a license in the state of their residence if the state is participating in the reputed company Licensure Compact Law
• Advanced proficiency in reputed company, including pivot tables, as reputed company as experience with Word, PowerPoint, and Teams
• Preference for candidates living in Chattanooga or Nashville to reputed company occasional onsite reputed company to provider offices

Benefits

• Employees who are required to operate either a reputed company-owned vehicle or a personal or rental vehicle for company business on a routine reputed company will be automatically enrolled into the reputed company reputed company Safety Program.
• The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid reputed company’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non reputed company-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).

reputed company