RN LTSS Auditor & Quality Risk Analyst

Molina Healthcare, Inc.; Wisconsin; On-site; USD 40,000 - 78,000; Full time

Job summary

Molina Healthcare, Inc. is seeking an RN with LTSS/audit experience to support clinical auditing of long-term services and supports.

You will review care management records, identify health and safety risks, and help ensure timely remediation while preserving member confidentiality. Responsibilities include conducting retrospective and concurrent audits, analyzing data to spot trends, reporting findings to leadership, and helping develop training materials to address audit results within a

Qualifications

• RN license active and unrestricted in state of practice.
• 3+ years healthcare experience, preferably in LTSS, QA, or utilization management.
• Experience with data, reports, or audit results to identify trends and improvements.
• Strong analytical and problem‑solving skills.
• Proficiency with Excel and Office software.

Responsibilities

• Conduct audits of LTSS, HCBS, care management records and related documents.
• Identify risks and ensure mitigation strategies are documented and escalated as needed.
• Analyze data to identify trends affecting member health and safety.
• Validate data quality and maintain traceability to source documentation.
• Report outcomes and communicate findings to leadership.
• Assist with developing training materials addressing audit findings.
• Maintain HIPAA confidentiality and professional conduct.

Skills

Data analysis

Analytical thinking

Attention to detail

Communication skills

Teamwork

Problem solving

Education

RN license

Bachelor’s degree in health care

Tools

Microsoft Office

Microsoft Excel

Job description

Molina Healthcare, Inc. is seeking an RN with LTSS/audit experience to support clinical auditing of long-term services and supports.

You will review care management records, identify health and safety risks, and help ensure timely remediation while preserving member confidentiality. Responsibilities include conducting retrospective and concurrent audits, analyzing data to spot trends, reporting findings to leadership, and helping develop training materials to address audit results within a