Clinical Quality Management Auditor
16 hours ago
We are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.
Key Responsibilities- Review and audit medical records to ensure compliance with AHCCCS AMPM requirements
- Analyze and track results to identify areas for quality improvement
- Develop and implement corrective action plans with providers to address any issues
- Collaborate with other health plans to prioritize providers for medical chart review
- Identify incomplete or inconsistent information in medical records and label missing measures/metrics/concerns
- Review and interpret medical records/data to determine whether there is documentation reflected accurately in medical records
- Follow relevant regulatory guidelines, policies, and procedures in reviewing clinical documentation
- Active and unrestricted LPN license in the state of Arizona
- 3+ years of experience in the Medicaid health field, including provider interactions
- 2+ years of experience reviewing medical record charts/documentation and writing regulatory reports
- Intermediate level of proficiency with software applications, including Microsoft Word, Excel, and Teams
- Reliable transportation for field visits
- Ability to travel 50% for the position throughout Arizona when business requires
- Paid Time Off and 8 Paid Holidays
- Medical Plan options, including Health Spending Account or Health Savings Account
- Dental, Vision, Life, and AD&D Insurance, as well as Short-term disability and Long-term Disability coverage
- 401(k) Savings Plan and Employee Stock Purchase Plan
- Education Reimbursement and Employee Discounts
- Employee Assistance Program and Employee Referral Bonus Program
We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented LPN Auditor looking for a challenging role in Clinical Quality Management, please apply today.
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Clinical Quality Management Auditor
19 hours ago
Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records to ensure compliance with AHCCCS AMPM...
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Clinical Quality Management Auditor
16 hours ago
Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records to ensure compliance with AHCCCS AMPM...
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Clinical Quality Management Auditor
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Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records from contacted medical providers to ensure compliance...
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Clinical Quality Management Auditor
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Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records to ensure compliance with Medicaid regulations and...
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Clinical Quality Management Auditor
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Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records from contacted medical providers to ensure compliance...
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Clinical Quality Management Auditor
15 hours ago
Tucson, Arizona, United States UnitedHealthcare Full timeJob SummaryWe are seeking a skilled LPN Auditor to join our Clinical Quality Management team at UnitedHealthcare. As a key member of our team, you will play a critical role in ensuring the quality and accuracy of medical records for Medicaid providers.Key ResponsibilitiesReview and audit medical records from contacted medical providers to ensure compliance...
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