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Nursing - Quality Auditor
Contract: Hopewell, New Jersey, US
Salary Range: 40.00 - 44.00 | Per Hour
Job Code: 364856
End Date: 2025-10-05
Days Left: 14 days, 0 hours left
We are hiring!
Job Title: Nursing - Quality Auditor
Location: Hopewell, NJ 08525 (Remote)
Duration: 4 Months (High Possible Extension)
Pay Range: $40/hr to $44/hr.
Benefits:
The Company offers the following benefits for this position, subject to applicable eligibility requirements: [medical insurance], [dental insurance], [vision insurance], [401(k) retirement plan], [life insurance], [long-term disability insurance], [short-term disability insurance], [paid parking/public transportation], [paid time off], [paid sick and safe time], [hours of paid vacation time], [weeks of paid parental leave], paid holidays annually] as applicable.
The Company offers the following benefits for this position, subject to applicable eligibility requirements: [medical insurance], [dental insurance], [vision insurance], [401(k) retirement plan], [life insurance], [long-term disability insurance], [short-term disability insurance], [paid parking/public transportation], [paid time off], [paid sick and safe time], [hours of paid vacation time], [weeks of paid parental leave], paid holidays annually] as applicable.
About the Role:
We are seeking a Quality Auditor to conduct quality audits for state audits, HEDIS, and quality referral and complaints issues. The role also involves preparing various reports on a weekly, monthly, quarterly, and year-end basis.
Responsibilities:
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Conduct on-site reviews at participating provider offices to assess environment, quality of physicians' medical records, and compliance with documentation standards.
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Prepare documentation summarizing on-site findings with physicians, providing education and discussing improvement opportunities.
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Provide data support services to analyze trends/patterns for quality improvement and health management.
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Assist the Quality Management department with special projects and focused clinical studies.
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Perform related tasks or special studies as requested.
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Assist in training internal staff, providers, and vendors on programs and audit standards.
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Serve as the in-house representative and project lead for state audits.
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Analyze audit findings and produce various reports as requested.
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Coordinate and manage the Corrective Action Plan (CAP) process for assigned audit types.
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Conduct reaudits to ensure prior deficiencies were addressed.
Education Qualification:
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Requires three to five years of related business experience, preferably in the healthcare industry.
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Requires a License Practical Nurse License or an active New Jersey Registered Nurse License.
Required Skills:
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Knowledge of managed care principles and medical terminology.
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Familiarity with PC's and related software.
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Preferably, knowledge of URAC accreditation standards and HEDIS principles.
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Strong verbal and written communication skills.
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Excellent organization, analytical, problem-solving, conflict resolution, and decision-making skills.
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Proficiency in PC skills and presentation abilities.
Job Requirement
- LPN
- RN
- Quality Audit
Reach Out to a Recruiter
- Recruiter
- Phone
- Sneha Samanta
- sneha.samanta@collabera.com
Apply Now
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