Clinical Quality Nurse Auditor (Remote Registered Nurse) - Any city, OK, US, 99999

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

As a Clinical Quality Nurse Auditor (Remote Registered Nurse) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. 

We are seeking a talented individual for a Clinical Quality Nurse Auditor who is responsible for performing on-going assessments of the quality of work performed by clinical staff such as Nurse Reviewer and Clinical Auditors. This person is responsible for complex quality reviews to determine if decision by review staff matches medical records and approved review methodologies.  This person is also responsible for working closely with the other clinical Supervisors and Managers to ensure that Clinical Reviewers are producing work that meets internal quality standards.

Your role in our mission

It takes knowledge and experience to perform the role of reviewing Medicaid billing claims and helping our clients recover Medicaid funds to provide healthcare for those who need it most.

• Perform clinical reviews …