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
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