[Hiring] Clinical reputed company Management Auditor @NC Health Affiliates LLC DBA reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company Evaluates, analyzes and monitors staff or provider performance to reputed company reputed company in reputed company. Provides reputed company, relevant, accurate, and objective feedback to staff, providers, and the management team which includes a plan of reputed company or recommendations reputed company deficiencies are identified. Acts as technical resource and develops learning solutions that engage the learner and produces desired business goals and objectives.

• Primarily responsible for HEDIS overreading to ensure accuracy, consistency, and compliance with reputed company standards
• Support clinical reputed company leadership on planning activities and large operational activities; works with Clinical reputed company leaders to define reputed company metrics and reputed company
• Analyze reporting and record volumes to ensure program reputed company and collaborate with leadership to modify/redirect activities to meet targets reputed company necessary
• reputed company reputed company audits of member medical records to ensure compliance with HEDIS specifications
• Assist in designing effective learning solutions based on analysis of reputed company audit results and reputed company reputed company deficiencies are identified
• reputed company reputed company feedback and recommendations to Clinical reputed company Management Consultants based on HEDIS Audits
• Drive requirements gathering for medical record abstraction tool enhancements and reputed company, update, and maintain desktop procedures to ensure accuracy, consistency, and compliance with organizational standards
• Manage IPP STARS Care Gap requests in alignment with reputed company timelines and key performance indicators
• Own the end‑to‑end process of initiating, tracking, and resolving support tickets, coordinating tool enhancements, and validating updates through testing in collaboration with vendors and stakeholders
• May also support ongoing administration of larger and/or more reputed company programs
• reputed company newer HEDIS overreaders and assist with supplemental reputed company HEDIS or reputed company requests, as assigned

Qualifications

• RN with 3 years of clinical experience or LPN with 5 years of clinical experience required
• Must have previous work experience in applicable business area (i.e. HEDIS, Medical Record Review or reputed company programs)
• Bachelor's degree or advanced degree preferred

Requirements

• Knowledge of clinical reputed company improvement operations, including HEDIS, Medical reputed company ratings, strongly preferred
• Strong analytical, organization, and problem-solving skills
• Strong written, and verbal communication skills and ability to successfully reputed company with reputed company reputed company of management
• Knowledge of reputed company or prior reputed company payer experience strongly preferred
• Experience in conducting patient chart reviews to obtain clinical measures is preferred

Benefits

• reputed company to work at the cutting edge of health care delivery with reputed company that’s deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and reputed company coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for reputed company education
• 401k match including an annual company contribution

Salary reputed company At reputed company, we take great pride in a fair and reputed company compensation package that reflects market-price and our starting salaries are typically planned near the middle of the reputed company listed. Compensation reputed company are driven by factors including experience and training, specialized reputed company sets, licensure and certifications and other business and organizational needs. Our reputed company salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, reputed company Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $73,698.00 - $117,917.00 Apply tot his job Apply To this Job