A-Line Staffing is looking to hire a Registered Nurse to conduct Quality Improvement Audits for a well-known healthcare provider in the Woodland Hills area.
Please reach apply to April Wilson for immediate consideration~
Job Title: Quality Improvement Auditor (Clinical)
Location: Woodland Hills California 91367
SHIFT: Mon – Fri 8-5
PAY: $48 an hour, paid weekly
Ideal Candidate with case management and analytical experience. HM is looking more for an auditor, more than a clinical. She wants someone that knows how to audit, not someone that knows how to prepare a care plan. Auditors focus on closing the gaps and performing health risk assessments, while clinical-focused folks focus on finding the right intervention.
Description: Lead medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews.
- Lead clinical audits for provider medical records both remotely via electronic medical records and on site to assess performance, determine trends and compile written reports summarizing findings, including clinical recommendations to assure the delivery of quality services
- Lead case reviews to assess the clinical performance provided in the provider network, including written clinical summaries and recommendations
- Perform ongoing quantitative and statistical analysis of the business units performance data to include various contracted performance measures, service utilization and member/provider complaint and quality of care trends
- Coordinate with internal teams to assure audit requests are fully understood, accurately compiled and delivered timely
- Perform other performance and process improvement activities
- May be able to do 1-2 days remote, but MUST be local
- Bachelor’ s degree in Nursing, related field or equivalent experience.
- 3+ years of nursing or quality improvement experience.
- Experience in case management (Calmedi connect or special needs programs)
- Managing member case/preparing ICP plans that will help the member get back on track
- Familiarity with regulations for interdisciplinary care center/care plan
- Analytical skills- can create reports (excel and analyze data)
Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
401k after 1 year of employment: With employer match and profit sharing
- Competitive Pay Rate!
- Work Life Balance!
Electronic Medical Record
Business Process Improvement