Clinical Quality Auditor

4 days ago


Arizona City, Arizona, United States UnitedHealthcare Full time

At UnitedHealthcare, we're committed to simplifying the healthcare experience and creating healthier communities. We believe everyone deserves access to quality care, regardless of their background or socioeconomic status. As a Clinical Quality Auditor with our team, you'll play a vital role in ensuring that medical providers adhere to regulatory guidelines and deliver high-quality care to patients.

Job Summary

We're seeking an experienced LPN with a strong background in Medicaid health and provider interactions. The ideal candidate will have excellent analytical skills, attention to detail, and the ability to communicate effectively with healthcare professionals. This is a hybrid-remote role, requiring 50% in-state travel throughout Arizona.

Key Responsibilities:
  • Review and audit Medicaid EVV providers and medical records to ensure compliance with AHCCCS AMPM requirements
  • Analyze and interpret medical records to identify potential quality-of-care issues and fraud/waste/abuse
  • Develop and implement quality improvement plans with providers, educate them on proper medical record documentation, and follow up as necessary
  • Prioritize providers for medical chart review, identify incomplete/inconsistent information, and label missing measures/metrics/concerns
  • Maintain HIPAA requirements for sharing minimum necessary information and demonstrate knowledge of public healthcare insurance industry products
About UnitedHealth Group

Our mission is to help people live healthier lives and make the health system work better for everyone. We believe in creating a diverse and inclusive workplace where everyone has the opportunity to succeed. If you're passionate about delivering exceptional patient care and making a meaningful impact, we encourage you to apply.

Requirements:
  • Active and unrestricted LPN license in the state of Arizona
  • 3+ years of experience in the Medicaid health field, including provider interactions
  • Intermediate level of proficiency with software applications (Microsoft Word, Excel, Teams)
  • Reliable transportation for field visits and ability to travel 50% for the position
Benefits

We offer a comprehensive benefits package, including:

  • Competitive base pay: $68,000 - $90,000 per year
  • Full and comprehensive benefit program
  • Performance rewards and opportunities for growth and development
  • Flexible work arrangements and work-from-home options

We're committed to attracting and retaining top talent who share our values and passion for delivering exceptional patient care. If you're ready to take your career to the next level and make a meaningful difference in the lives of others, apply today



  • Arizona City, Arizona, United States UnitedHealthcare Full time

    Unlock a Rewarding Career in Clinical Quality ManagementAt UnitedHealthcare, we're simplifying the healthcare experience and creating healthier communities. We're seeking an experienced Licensed Practical Nurse (LPN) to join our team as a Clinical Quality Management Auditor. As an LPN Auditor, you'll play a vital role in ensuring the quality of care provided...


  • Arizona City, Arizona, United States Clinical Management Consultants Full time

    Nursing Leadership OpportunityWe are seeking an experienced nursing leader to join our team as a Director of Clinical Operations at a prestigious acute care hospital in Southern Arizona.This exceptional opportunity offers the chance to lead strategic and operational initiatives across a range of inpatient units, enhancing patient outcomes, fostering a...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    Job Title: Clinical Therapist for Young ChildrenWe are seeking a highly skilled Clinical Therapist to join our team at Soar Autism Center in Mesa, Arizona. As a key member of our interdisciplinary clinic, you will play a vital role in providing high-quality care to young children with autism and their families.About the Role:This is an ongoing position...


  • Arizona City, Arizona, United States LHC Group Full time

    LHC Group is a leading provider of post-acute care services, and we are seeking an experienced Clinical Nurse Manager to join our team in Mesa, Arizona. With a focus on delivering high-quality, cost-effective care, we strive to reach more patients and families with effective and efficient healthcare.About the RoleThe successful candidate will have at least...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    Job Title: BCBA - Clinical Therapist">About Us: At Soar Autism Center, we are dedicated to providing exceptional care for children with autism spectrum disorder (ASD). Our focus is on early intervention, integrated autism care, and play-based ABA therapy aligned with principles of the Early Start Denver Model (ESDM).">Job Summary:">We are seeking a Board...

  • Clinical Supervisor

    6 days ago


    Arizona City, Arizona, United States Life Skills Autism Academy Full time

    We are seeking an experienced Clinical Supervisor to join our team at Life Skills Autism Academy. As a Clinical Supervisor, you will be responsible for overseeing ABA therapy and guiding a team of Behavior Technicians to ensure high-quality clinical standards are met.About UsLife Skills Autism Academy is a leading provider of Applied Behavior Analysis (ABA)...

  • Clinical Specialist

    7 days ago


    Arizona City, Arizona, United States TotalMed Staffing Full time

    Job Title: Clinical Specialist - Pediatric Emergency RoomAbout the Role:TotalMed Staffing is seeking a skilled Clinical Specialist to join their team in Mesa, Arizona. As a key member of the pediatric emergency room team, you will be responsible for providing high-quality patient care and supporting the clinical staff in delivering exceptional patient...


  • Arizona City, Arizona, United States AB Staffing Solutions Full time

    Seeking a highly skilled Licensed Clinical Social Worker for a 13-week travel assignment in Mesa, Arizona. The ideal candidate will possess excellent clinical and interpersonal skills to provide high-quality patient care.About the JobThis opportunity offers an estimated weekly salary of $2,400 - $3,600 (based on 40 hours/week) with tax-free stipend amount to...

  • Clinical Specialist

    4 weeks ago


    Arizona City, Arizona, United States Soar Autism Center Full time

    About the RoleWe are seeking a highly skilled and dedicated Board Certified Behavior Analyst to join our interdisciplinary team at Soar Autism Center. As a key member of our clinical staff, you will play a crucial role in delivering high-quality, evidence-based services to young children with autism and their families.About the JobThe successful candidate...

  • Clinical Therapist

    7 days ago


    Arizona City, Arizona, United States Soar Autism Center Full time

    **Early Intervention Expert Wanted at Soar Autism Center**We are seeking a dedicated Clinical Therapist to join our interdisciplinary team at Soar Autism Center. As an expert in early intervention, you will play a vital role in shaping the lives of children with autism and their families.**About Us**At Soar Autism Center, we prioritize early intervention,...


  • Arizona City, Arizona, United States Arizona Autism United Full time

    About Our OrganizationAt Arizona Autism United, we prioritize providing high-quality direct services and supports to children and families in our community. As a leading nonprofit organization, we strive to create a positive impact by fostering a culture of compassion, understanding, and growth.A Competitive Salary PackageWe offer an attractive salary range...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    About Soar Autism CenterSoar Autism Center is a leading provider of comprehensive services for children with autism. Our mission is to empower young individuals to reach their full potential through early intervention, supportive therapy, and individualized care.We are creating a network of interdisciplinary clinics dedicated to delivering high-quality,...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    Unlock Your Potential as a Clinical ABA TherapistAt Soar Autism Center, we're dedicated to delivering exceptional care for children with autism spectrum disorder (ASD). As a Board Certified Behavior Analyst (BCBA), you'll play a vital role in our interdisciplinary team, working closely with clinical teams to provide individualized, naturalistic ABA...


  • Arizona City, Arizona, United States Care Options for Kids Full time

    Care Options for Kids: A Unique Opportunity for Speech-Language PathologistsWe are seeking a motivated and dedicated Speech-Language Pathologist to join our team as a Clinical Fellow in a dynamic home health setting. This role offers a chance to gain hands-on experience, balance work and personal life, and jump-start your career with maximum support.About...


  • Arizona City, Arizona, United States Assisted Home Health & Hospice Full time

    Assisted Home Health & Hospice is seeking a skilled Registered Nurse to join our Hospice Division as a Clinical Care Specialist. This role plays a vital part in ensuring the delivery of high-quality patient care and creating individualized plans tailored to each patient's unique needs.About the JobWe are looking for an experienced RN with a strong background...


  • Arizona City, Arizona, United States Sonora Quest Laboratories Full time

    Job Description:This role is designed for a Medical Lab Scientist I with expertise in clinical testing, complex problem-solving skills, and department resource. The successful candidate will be responsible for performing high-level technical knowledge and applying it to various laboratory procedures.Key Responsibilities:Testing and Quality Control: Perform...


  • Arizona City, Arizona, United States Care Options for Kids Full time

    Speech Language Pathologist OpportunityWe are seeking a highly skilled Speech-Language Pathologist to join our team at Care Options for Kids. This is an exceptional opportunity to work with children and help them overcome barriers, achieve milestones, and flourish.About the RoleDeliver high-quality speech therapy services to children in a supportive and...


  • Arizona City, Arizona, United States Medix Full time

    Medix OpportunityMesa, Arizona is home to this permanent, direct-hire Nursing Professional opportunity. The estimated salary for this position is $80,000 per year.About the JobThis Nursing Professional will adhere to clinical workflows and perform daily nursing activities, including patient triage and education. They will collaborate with Providers and the...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    Soar Autism Center, a leader in autism care, is seeking a skilled Communications Specialist to join their team. This role offers the opportunity to make a meaningful impact on the lives of children and families affected by autism.About the JobThis full-time position involves working as an on-site Communications Specialist for children ages 2-6 in a...


  • Arizona City, Arizona, United States Soar Autism Center Full time

    Company OverviewSoar Autism Center is a leading provider of interdisciplinary clinics, offering life-changing services to children with autism and their families. Our mission is to advance the standard of care for young kids with autism through high-quality, ethical services.Salary:$88,500 - $112,000 per year, plus potential for a $6,000 sign-on bonus*Job...