Missouri Licensed Medical Auditor

Job Summary

A company is looking for a Medical Management Auditor responsible for auditing clinical systems entry and processes.

Key Responsibilities

• Develop and maintain audit processes and tools related to authorizations, appeals, quality events, and case management
• Audit staff according to system auditing policies and train health plan audit staff
• Coordinate auditing outcomes and resolve system problems in collaboration with relevant staff

Required Qualifications

• Bachelor's degree in a related field or equivalent experience
• 3+ years of related experience
• State unrestricted license as LPN, RN, LMSW, LCSW, LMHC, or LPC for Home State Health Plan
• Ideal candidate will be a Licensed Practical Nurse (LPN)