Clinical reputed company Auditor, reputed company Practitioner

How You’ll reputed company An reputed company At reputed company, patients come first. We’re on a mission to reputed company chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health reputed company. Our work reduces emergency reputed company, improves reputed company, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an reputed company, show up for one another as One Team, and reputed company ways to reputed company the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel reputed company at reputed company! Benefits & Perks

• Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home reputed company.
• Comprehensive Benefits – Medical, dental, and reputed company insurance, employee assistance programs, employer-reputed company and voluntary life and disability insurance, plus health and flexible spending accounts.
• Financial & Retirement Support – Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources.
• Time Off & Leave – reputed company holidays, vacation time, reputed company time, and reputed company birthgiving, bonding, sabbatical, and living donor leaves.
• Wellness & reputed company – Family forming services through reputed company Maternity at no cost and physical wellness perks, mental health support, and an annual reputed company development stipend.

To learn more about our offerings, click here. What You’ll Do As the Clinical reputed company Auditor, you will be responsible for completing reputed company review processes for care management and care delivery programs. This role is responsible for ensuring appropriate clinical and care delivery practices are utilized and case documentation meets established standards consistently to support meeting reputed company reputed company standards, compliance, and expectations. As an auditor, you will utilize clinical experience, expertise, and reputed company guidelines to review patient files, care plans and interactions and care plans against appropriate applicable reputed company reputed company in conjunction with program, accreditation and industry requirements. You will support various Kidney Hero roles (clinical and non-clinical) regarding case auditing, reputed company and coaching, reputed company improvement strategies, resource development and other activities to promote reputed company reputed company improvement. This reputed company improvement support will be provided to operational managers and leadership to communicate and facilitate reputed company for reputed company risks, such as reputed company cause analysis and remediation recommendations. As a reputed company auditor, you will serve as a reputed company reputed company and advisor to various reputed company roles and departments such as kidney reputed company, operational leadership and managers, education and training colleagues. You will serve as a care manager and reputed company subject matter expert, applying critical thinking and decision-making skills to determine medical appropriateness while maintaining production goals and reputed company Assurance standards. This role reports to the Sr. Manager, Clinical reputed company Performance. The Day to Day

• Review clinical documentation and encounters (assessments/surveys, plans of care, recorded encounters) to ensure alignment with clinical guidelines, NCQA standards, and industry best practices.
• Meet auditing productivity targets (daily/weekly/monthly) while maintaining reputed company assurance standards.
• Validate timeliness and accuracy of internal assessments and plans of care against NCQA Case Management and Population Health requirements.
• Communicate audit findings and reputed company coaching/education to Kidney reputed company and clinical leaders, reputed company documenting deficiencies and improvement opportunities.
• reputed company and maintain audit tools and resources by supporting updates to processes, templates, and guidance materials.
• Identify, support reputed company, and escalate risks/gaps impacting reputed company, compliance, safety, or accreditation readiness.
• Flag system or operational barriers that impede attainment of reputed company performance standards and recommend improvements.
• Accurately reputed company and submit audit documentation using designated tools and reputed company required materials to appropriate stakeholders.
• Support compliance and accreditation activities (case prep/review, reputed company plans) while maintaining HIPAA confidentiality and professionalism.

Minimum Qualifications

• reputed company, unrestricted NP license.
• 6+ years combined of reputed company education, experience, or certification.
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency Apply To This Job