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RN, Clinical Compliance Specialist - Remote Eligible

Lead clinical compliance investigations to ensure the highest quality of member care.
Remote
Mid-Level
$60,522 - 129,615 USD / year
1 month ago

✨ About The Role

- The RN Clinical Compliance Specialist will be responsible for maintaining policies and processes related to clinical compliance. - This role involves conducting audits, collecting, monitoring, and analyzing data to ensure compliance. - The specialist will lead clinical compliance investigations, applying clinical knowledge to interpret data findings and recommend next steps. - Effective communication of investigation findings to leadership is a key responsibility of this position. - The role also includes supporting the office of the CMO and the Clinical Success team, as well as researching best practices in clinical compliance.

âš¡ Requirements

- The ideal candidate will possess an RN degree, either an associate or bachelor's, demonstrating a solid foundation in nursing. - A minimum of 3 years of experience in a healthcare setting is required, with a preference for those familiar with clinical coding guidelines. - Candidates should be self-motivated and able to take the initiative to learn new programs and policies independently. - Flexibility and a positive attitude are essential, as the role involves working in a fast-paced environment with changing priorities. - Strong analytical skills are necessary to read, analyze, and interpret various documents, as well as to write reports and business correspondence effectively.
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RN, Clinical Compliance Specialist - Remote Eligible
Remote
$60,522 - 129,615 USD / year
Registered Nurse
About CVS Health