Remote Network Compliance Auditor – Healthcare

Scan-Health-Plan; Long Beach (CA); On-site; USD 53,000 - 77,000; Full time

Benefits offered by this job

Remote/Field work

Annual bonus

Wellness program

PTO + holidays

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a regulated and detail-oriented Registered Nurse to lead audits for the Department of Health Care Services. You will review DHCS guidelines, perform Facility Site Reviews and Medical Record Reviews, and train providers on compliance and corrective action plans.

This role covers remote/field work across assigned territories and requires driving. Ideal candidates hold a CA RN license with 2+ years clinical experience, auditing background preferred, and the ability to

Qualifications

• RN license required (CA) in good standing.
• 2+ years clinical experience (ER/Acute Care).
• IPA/Medical Group experience preferred.
• Associates degree in nursing; Bachelor's preferred.
• DHCS-CSR (certified site reviewer) preferred.
• Prior auditing experience preferred.
• Ability to work independently and with a team.
• Strong communication, analytical and organizational skills.

Responsibilities

• Audit PCP sites per DHCS APL; ensure compliance.
• Train auditees on auditing processes and documentation.
• Conduct closing meetings with providers and provide overviews.
• Develop and implement CAPs; monitor progress and provide education.
• Respond to disagreements with audit findings.
• Review legislation, contract language and regulatory guidance.

Skills

RN license CA

2+ years clinical experience

Audit experience preferred

Driver license

Education

Associates degree in nursing

Bachelor's degree preferred

DHCS-CSR certification preferred

Tools

MS Office

Job description

SCAN Health Plan is seeking a regulated and detail-oriented Registered Nurse to lead audits for the Department of Health Care Services. You will review DHCS guidelines, perform Facility Site Reviews and Medical Record Reviews, and train providers on compliance and corrective action plans.

This role covers remote/field work across assigned territories and requires driving. Ideal candidates hold a CA RN license with 2+ years clinical experience, auditing background preferred, and the ability to