JOB DESCRIPTION

This position will offer remote work flexibility, but the selected candidate must reside in Nebraska.

Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with NCQA standards is vital to success in this role. The preferred candidate will have 3 – 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Hours are Monday – Friday, 8AM – 5PM in your time zone.

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuri...