Clinical - Quality Improvement Auditor (Clinical) - 210664
Position Title: Quality Improvement Auditor Location: Remote (Nationwide) Duration: 4 Months Schedule: Monday Friday, 8:00 AM 5:00 PM AZ Time (1-hour lunch). Occasional OT with manager approval. Responsibilities: • Lead medical record audits remotely through EMRs. • Review provider documentation to assess performance and identify trends. • Compile written reports summarizing findings and clinical recommendations. • Conduct clinical case reviews and prepare written summaries. • Perform ongoing quantitative/statistical analysis of performance data, including HEDIS measures, utilization, complaints, and quality-of-care trends. • Coordinate with internal teams to ensure audit requests are understood and delivered accurately and on time. • Review 50 100 medical records per day (measure-dependent) with 95%+ accuracy. • Support performance and process improvement activities. • Comply with all policies and standards and perform additional duties as assigned. Requirements: Education & Licensure (Required): • Bachelor s degree in Nursing or related field, or equivalent experience. • Active clinical license (RN, LPN, LVN). Experience (Required): • 3+ years of nursing or quality improvement experience. Must-Have Skills: • Knowledge of HEDIS Hybrid Measures. • Proficiency with TEAMS, Excel, EMRs, QMRM. • Strong organization and ability to meet deadlines. Preferred: • Previous HEDIS experience. • Experience in quality improvement or clinical auditing. Remote About the Company: Pacer Group Apply tot his job