Remote HEDIS Clinical Quality Auditor - Contract

Walker Healthforce, Inc.

New Jersey

Hybrid

USD 65,000 - 95,000

Full time

4 days ago

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Benefits offered by this job

Competitive compensation package

Weekly pay via Direct Deposit

Medical, Dental & Vision available

401k options

Job summary

Walker Healthforce is seeking a HEDIS Clinical Quality Auditor for a remote contract role. The ideal candidate has 3-5 years of healthcare auditing experience and active LPN or NJ RN license, with strong analytical and communication skills.

Responsibilities include conducting office reviews, auditing medical records, and supporting quality improvement initiatives, with weekly pay and benefits offered. Start ASAP; remote within New Jersey.

Qualifications

3-5 years of related business experience, preferably within the healthcare industry.
Licensed Practical Nurse license or active New Jersey Registered Nurse license
Valid driver's license and access to an automobile
Knowledge of managed care principles and medical terminology
Strong analytical, organizational, communication, and presentation skills
Strong problem-solving, decision-making, and PC skills

Responsibilities

Conduct on-site provider office reviews to assess medical records, documentation standards, and quality requirements.
Prepare documentation summarizing audit findings and educational opportunities.
Analyze audit findings, trends, and patterns to support quality improvement activities.
Assist with special projects, focused clinical studies, and state audits.
Provide training to staff, providers, and vendors regarding programs and audit standards.
Prepare quality-related reports as requested.
Coordinate Corrective Action Plans for assigned audit types.
Conduct re-audits to confirm identified deficiencies have been addressed.