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Clinical - Quality Improvement Auditor (Clinical) - 210664
Mindlance
- 🇺🇸 United States
- Remote
- 20 hours ago
- LPN
20 hours ago
Not enough detail in this posting to match
Position Purpose:
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.
Education/Experience:
Bachelor’s degree in nursing, related field or equivalent experience and requires an clinical license. 3+ years of nursing or quality improvement experience.
Licenses/Certifications: Current state’s clinical license (LPN, RN, etc.).
Responsibilities
Lead clinical audits for provider medical records both remotely via 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 quality services
Lead case reviews to assess the clinical performance provided in the provider network, including written clinical summaries and recommendations
Perform 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 quality of care trends
Coordinate with internal teams to assure audit requests are fully understood, accurately compiled and delivered timely
Perform other performance and process improvement activities
Performs other duties as assigned
Complies with all policies and standards
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Clinical - Quality Improvement Auditor (Clinical) - 210664 · Mindlance