Offer summary
Qualifications:
Bachelor's degree preferred, Minimum 3 years clinical experience required, Minimum 3 years clinical quality/audit experience strongly preferred, Active NJ RN, LCSW, LMFT, LSW or LPC License Required, HEDIS experience strongly preferred.
Key responsabilities:
- Conduct file audits for compliance with regulatory standards
- Analyze and distribute audit outcomes to Business Unit Directors
- Maintain CMS-CAPs documentation and communicate results to Directors
- Facilitate biannual MCG-IRR testing for staff
- Conduct ad hoc audits for new business practices adherence