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Remote Quality Improvement Auditor (clinical) – LTC
Lead clinical audits for provider medical records to ensure quality service delivery.
Arizona, USA
Senior
$54,000 - 97,100 USD / year
6 months ago
Centene
Transforming the health of the communities we serve, one person at a time
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✨ About The Role
- Lead medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member outcomes
- Assess provider performance and quality of care through clinical case reviews and compile written reports summarizing findings
- Conduct clinical audits for provider medical records both remotely and on site to determine trends and compile recommendations
- Perform ongoing quantitative and statistical analysis of the business unit’s performance data including various contracted performance measures
- Coordinate with internal teams to ensure audit requests are understood, compiled accurately, and delivered timely
⚡ Requirements
- Experienced professional with a Master's degree in Healthcare Management, Business Management, Social Work, or related field
- Skilled in performance and statistical analysis or quality improvement with at least 3 years of relevant experience
- Proficient in Microsoft Office applications and previous experience in public sector managed care or managed behavioral health care is preferred
- Holds a valid license such as LCSW, LMFT, LPC, LISAC, or RN in Arizona, with additional certifications like CPHQ being advantageous
- Capable of leading medical record audits, clinical case reviews, and analyzing provider performance to ensure quality care delivery
Remote Quality Improvement Auditor (clinical) – LTC
Various
$54,000 - 97,100 USD / year
Remote
About Centene
Transforming the health of the communities we serve, one person at a time