Clinical Compliance Auditor – Remote/Field RN

SCAN Health Insurance; Long Beach (CA); Remote; USD 53,000 - 77,000; Full time

Benefits offered by this job

Remote/Field work across assignedTerr

Annual bonus program

Wellness Program

PTO with 11 holidays + birthday off +

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Insurance seeks a Registered Nurse to oversee the Managed Care Plan auditing team aligned with DHCS reviews of PCP sites. The role focuses on compliance, documentation, and implementing corrective actions to uphold quality standards.

The ideal candidate holds an active California RN license with 2+ years of clinical experience, and is comfortable with a remote/field work model that involves travel within the assigned territory.

Qualifications

• Registered Nurse License required (current and active California license in good standing).
• 2+ years clinical experience including but not limited to ER/Acute Care nursing required.
• Associate’s Degree in Nursing or higher; Bachelor’s Degree preferred.

Responsibilities

• Conducts detailed review and interpretation of DHCS All Plan Letters and related materials.
• Identify regulatory compliance improvements and develop implementation plans.
• Audit SCAN contracted PCP offices to ensure CMS, DHCS, and contractual compliance and train on audit processes.

Skills

Registered Nurse

CA RN license

Analytical thinking

Education

Associate’s Degree in Nursing

Bachelor’s Degree preferred

Tools

MS Office

Data entry

Job description

SCAN Health Insurance seeks a Registered Nurse to oversee the Managed Care Plan auditing team aligned with DHCS reviews of PCP sites. The role focuses on compliance, documentation, and implementing corrective actions to uphold quality standards.

The ideal candidate holds an active California RN license with 2+ years of clinical experience, and is comfortable with a remote/field work model that involves travel within the assigned territory.