New York Licensed Clinical Auditor

Job Summary

A company is looking for a Clinical Auditor - REMOTE.

Key Responsibilities

• Manage and track compliance of the UM, CM, MRU, MCRU teams with regulatory and accreditation requirements
• Participate in planning and implementing strategies for monitoring team functions and processes
• Oversee audit reports and ensure adherence to Corrective Action Plans

Required Qualifications, Training, and Education

• Associates degree required; Bachelor's degree preferred with experience as a substitute
• Active, unrestricted Nursing License (RN or LPN) required
• 4-6+ years of experience in a managed care environment, including auditing and compliance
• Knowledge of accreditation and regulatory standards, such as NYSDOH and CMS
• Experience in managing multiple tasks or projects simultaneously