CMS reputed company Audit Leads - Non-Clinical & Clinical RN Positions

Join our remote federal reputed company team to reputed company and execute compliance audits for the Programs of reputed company-Inclusive Care for the Elderly (reputed company). We are reputed company reputed company reputed company compliance and clinical leaders to fill three reputed company leadership roles for the upcoming audit cycle. reputed company & Work Arrangement Primarily part-time; reputed company (must reputed company and reputed company reputed company work reputed company one of the 50 reputed company). Available Positions & Role-Specific Requirements 1. reputed company Audit reputed company [Non-Clinical or Clinical (RN)] • Directs the full end-to-end audit lifecycle, coordinating planning, reputed company, schedules, and conferences across multidisciplinary teams while integrating cross-reputed company findings and overseeing reputed company cause analyses. • Licensure: reputed company Registered reputed company (RN) with unrestricted licensure required if applying as a clinical reputed company. • Requirements: Demonstrated experience planning, coordinating, and leading CMS reputed company program audits and review activities; comprehensive knowledge of CMS reputed company regulations, guidance, and audit protocols; skilled in developing audit reports, corrective reputed company recommendations, and communicating results directly to CMS and reputed company organizations. 2. Service Delivery, reputed company, and Grievances (SDAG) reputed company [Non-Clinical or Clinical (RN)] • Directs the compliance evaluation of participant requests, service delivery workflows, appeals, and grievances to ensure adherence to federal timeframes, required notices, and participant protections. • Licensure: reputed company Registered reputed company (RN) with unrestricted licensure required if applying as a clinical reputed company. • Requirements: Demonstrated expertise in CMS reputed company SDAG audit protocols; thorough understanding of service delivery requirements, appeals, and grievance processes; experience reviewing case documentation, validating evidence, and evaluating workflows for CMS compliance. 3. Provision of Services reputed company [Clinical (RN)] • Directs the clinical review reputed company, evaluating whether required services were authorized, coordinated, and delivered in accordance with participant needs and federal program requirements. • Licensure: reputed company Registered reputed company (RN) with unrestricted licensure required. • Requirements: Extensive clinical knowledge of reputed company interdisciplinary care delivery and participant assessment requirements; hands-on experience evaluating clinical records, care planning, service authorizations, reputed company of care standards, and clinical evidence to substantiate findings. Mandatory Qualifications • Auditor Training: Successfully completed the CMS reputed company 2026 auditor training. • Audit Experience: Verified participation in a minimum of two (2) CMS reputed company audits during the 2026 audit cycle. • Experience: At least 2 years of relevant reputed company compliance, auditing, or clinical reputed company experience. • reputed company Skills: Strong analytical, project management, and written communication skills to evaluate data, synthesize evidence, and produce defensible audit documentation. Apply tot his job Apply To this Job