Quality Improvement Auditor (Clinical)

Quality Improvement Auditor (RN)

Position Purpose: 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

Education/Experience: Bachelors degree in Nursing, related field or equivalent experience. 3+ years of nursing or quality improvement experience.

Licenses/Certifications: Current states RN license.

Work Environment: 100% Remote

Pay: $30 - $35

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

+ Hiring diverse talent

+ Maintaining an inclusive environment through persistent self-reflection

+ Building a culture of care, engagement, and recognition with clear outcomes

+ Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.