About the role

  • Health Plans LPN Auditor conducting independent chart reviews for Arizona's health plans. Collaborating with facilities to ensure compliance with quality standards and regulations.

Responsibilities

  • Independently review patient medical charts for compliance
  • Provide feedback and assistance to facilities for compliance
  • Perform quality medical record reviews and data analysis
  • Monitor and track Corrective Action Plans (CAPs)
  • Report potential risk or compliance issues
  • Support continuous improvement in Medical Management

Requirements

  • Current, unrestricted State of Arizona LPN license
  • Two years of experience, preferably in a family practice or pediatric medical office setting
  • Excellent verbal and written communication skills
  • Strong collaborative skills
  • Knowledge and understanding of HEDIS specifications
  • Knowledgeable of NCQA, HEDIS, AHCCCS, and CMS standards and reporting requirements

Benefits

  • Comprehensive benefit package
  • Professional development opportunities
  • Flexible work arrangements

Job title

Health Plan LPN Auditor

Job type

Experience level

JuniorMid level

Salary

$26 - $44 per hour

Degree requirement

Professional Certificate

Location requirements

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