Remote Clinical Data Audit & Compliance Analyst

Centene; California; Remote; USD 47.000 - 84.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Zusammenfassung

Centene is seeking a Clinical Data Audit Consultant to oversee the clinical content component of data collection, audits, and account implementations for Clinical Operations. This role suits candidates with strong analytical skills and clinical data management experience, including supporting HEDIS, URAC, and NCQA compliance.

The position offers a remote CA location, full-time day shift, and competitive benefits such as health insurance and 401K.

Qualifikationen

• BA/BS in Psychology, Nursing, or related clinical field; Masters preferred.
• 3-5 years case management or related clinical experience.
• 2-3 years experience in business studies or analysis, preferably in Healthcare.
• Licensed Clinician and/or RN required; current license required.

Aufgaben

• Gather and analyze data for clinical operations.
• Create workflows and coordinate internal and external audits.
• Review, analyze, and interpret data for HEDIS, URAC, NCQA compliance.
• Address and participate in training of clinical staff based on data analysis.
• Identify, evaluate, and document clinical business needs and objectives.
• Produce documentation including project plans and analytical reports.
• Recommend operational and process improvements.
• Maintain a repository of performance and audit metrics.
• Conduct secondary research using health statistic databases.
• Organize and compile cases for external audits.

Kenntnisse

Data analysis

Audit coordination

Clinical data management

Healthcare analytics

Ausbildung

BA/BS in Psychology, Nursing, or related clinical field

Masters preferred

Jobbeschreibung

Centene is seeking a Clinical Data Audit Consultant to oversee the clinical content component of data collection, audits, and account implementations for Clinical Operations. This role suits candidates with strong analytical skills and clinical data management experience, including supporting HEDIS, URAC, and NCQA compliance.

The position offers a remote CA location, full-time day shift, and competitive benefits such as health insurance and 401K.