This job board retrieves part of its jobs from: Toronto Jobs | Emplois Montréal | IT Jobs Canada

The New York State wants YOU to start a career here!

To post a job, login or create an account |  Post a Job

RN Clinical Auditor – Registered Nurse

Response Companies

This is a Full-time position in New York, NY posted July 13, 2021.

We have an exciting opportunity for an RN Utilization Management Clinical Auditor
– Registered Nurse, at our prestigious managed care company client.

The RN Utilization Management (UM) Clinical Auditor is responsible for oversight and monitoring of the medical management department and will conduct audits to assess for compliance of clinical mandates of New York State and federal regulatory institutions (NYSDOH and CMS) and will contribute and implement corrective action plans, when needed.

The incumbent in this role will ensure maintenance of UM policies and procedures with regard to compliance with NYSDOH and CMS regulations, as well as monitor regulatory changes, train both clinical and non-clinical company staff, and create compliance tracking, trending, and reporting tools.

Qualified candidates must have a New York State Registered Nurse (RN) License in good standing and a Bachelor’s Degree from an accredited institution.

At least 2 years’ experience in Utilization Management (UM), quality assurance, and clinical audit within managed care/health insurance is required as well as knowledge of Medicare, CMS, and NYSDOH regulatory guidelines.

Company provides an excellent compensation and benefits package, including medical, dental, and vision, 401K with company match, tuition reimbursement, life insurance, FSA, HRA, paid vacation/sick/holidays, etc.

Interested candidates please submit your updated resume for consideration to .