Senior Medical Auditor

3 weeks ago


Oakland, California, United States Blue Shield of CA Full time

As a key member of the Facility Compliance Review Team, you will be responsible for ensuring post-service prepayment facility claims meet strict compliance standards. The role of Senior Utilization Management Nurse requires strong analytical and problem-solving skills to review medical documents and apply clinical criteria for determining the most suitable level of care.

Key Requirements

  • Bachelor's of Science in Nursing or advanced degree
  • Current California RN License
  • Typically 5+ years of relevant experience and college degree or equivalent
  • Advanced knowledge of job area and strong analytical/problem-solving skills

Compensation:

We offer a competitive salary ranging from $87,230.00 to $130,900.00 per year, based on location and experience.



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