Clinical Performance Auditor – CDI

Job Description: • Plans, designs, develops and performs quality assessments on data elements and structures to document and evaluate integrity, completeness, quality, and appropriateness of formats, records and structures • Configures, operates and develops manual and/or automated methods, processes and procedures to test output or input based on data compliance, quality and use requirements as established by product management, client specifications, and governance programs • Performs regular and ad hoc reviews, audits, and investigations of data activity and integrity; prepares reports and summaries of findings • Produces and updates guidelines and documentation of test development processes, procedures and standards • Complete record reviews on client records to identify best practice process improvement opportunities • Complete data analysis of reviews completed and create summary presentations for internal and external communication of record review results • Engage with client utilization management teams and provide feedback regarding record review and education associated with identified opportunities for best practice improvement • Develop and provide education regarding clinical concepts to clients and internal stakeholders and product designers • Participate in product performance audits and communicate results with product team • Perform medical record review to support product innovation and development • Audit performance of key data science conditions and elements Requirements: • Bachelor’s Degree or equivalent in Nursing (RN) • 5+ years of experience in utilization management and/or clinical documentation and auditing • Self-starter, who is extremely motivated to demonstrate success • Attention to detail, highly organized, with an absolute focus on quality of work • Team player DNA with a desire to solve for the interests of our clients and of our business Benefits: • Competitive total rewards (base salary + bonus, if applicable) • Customizable benefits package (3 medical plans with Health Saving Account company match) • Generous paid time off for non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays • Flexible time off for exempt team members + 13 paid holidays • Paid parental leave (including maternity + paternity leave) • Education assistance opportunities and free LinkedIn Learning access • Free mental health and family planning programs, including adoption assistance and fertility support • 401(K) program with company match • Pet insurance • Employee resource groups Apply Now Apply Now