Medical Management Accreditation & Audit Coordinator – Work From Home
Core
Conduct audits and monitor quality improvement activities within the medical management program to ensure compliance with policies and regulatory requirements.
Role type
Senior IC medical management auditor
Builds
Compliance reports and quality improvement initiatives for internal committees
Domain
Healthcare administration and utilization management
Deliverable
dashboards & analysis
Required skills
Utilization review, case management, quality improvement, regulatory compliance, report preparation, policy analysis
Preferred skills
CPHQ certification, audit experience, health plan experience, Bachelor's in Nursing or Health Administration
Technologies
Microsoft Office
Responsibilities
Conduct audits of medical management programs, monitor ongoing quality improvement activities, analyze compliance with departmental and regulatory requirements, prepare reports for management presentation, serve as a resource on quality and utilization issues
Seniority
Mid-level, hands-on IC