Overview
Skills
Job Details
Immediate need for a talented Quality Auditor (LPN). This is a 03+months contract opportunity with long-term potential and is located in Phoenix,AZ(Hybrid). Please review the job description below and contact me ASAP if you are interested.
Job ID:25-70846
Pay Range: $32 - $34/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- This position will be assigned cases and will carry their own caseload, tracking due dates of 30-60 dates from the date assigned, to ensure timely completion and submission of investigation to AHCCCS.
- Expectation is that the individual contributor communicates concerns or questions and manage their caseload appropriately.
- 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
Key Requirements and Technology Experience:
- Key Skills: LPN
- Quality
- Provider
- 2+ years clinical, quality management or healthcare related experience.
- At least one year experience in quality function in a healthcare setting.
- Required: i.e RN, BSN, LPN, etc.
Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
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