Health Plans Licensed Practical Nurse, LPN Auditor
Banner Health
part-time
Posted on:
Location Type: Hybrid
Location: Phoenix • Arizona • United States
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Salary
💰 $26 - $44 per hour
About the role
- Independently review patient medical charts to assess compliance to AHCCCS and other regulatory rules.
- Make initial determinations based on clinical findings and documentation.
- Provide feedback and assistance to help the facilities reach compliance or maintain compliance.
- Assist in the development of clinical medical record audit tools and processes.
- Conduct data analysis using Microsoft Excel.
- Coordinate, retrieve, and perform medical record audits to determine provider compliance.
- Monitor and track Corrective Active Plans (CAPs).
- Provide written documentation and Corrective Action Plans as directed by the Credentials Committee.
- Report potential risk or compliance issues identified in the audit process to the Manager/Supervisor of QM.
- Coordinate and prepare monthly provider profile data reports for the Credentialing Department.
Requirements
- Current, unrestricted State of Arizona LPN license.
- Two years of experience, preferably in a family practice or pediatric medical office setting.
- Ability to travel to all contracted sites, which may necessitate occasional overnight stays.
- Excellent verbal and written communication skills.
- Strong collaborative skills (ability to work with a team or individually).
- An aptitude for accuracy with attention to detail.
- Knowledge and understanding of HEDIS specifications.
- Strong leadership skills (can construct a vision, thinks creatively to solve issues and is goal oriented).
- Ability to maintain strict confidentiality along with good problem solving and investigative skills.
- Ability to set appropriate priorities relative to work load in a fast paced environment.
- Knowledgeable of the National Committee for Quality Assurance (NCQA), Health Plan Employer Data Information Set (HEDIS), Arizona Health Cost Containment System (AHCCCS) and Centers for Medicare and Medicaid Services (CMS) standards and reporting requirements.
Benefits
- Competitive wages
- Paid orientation
- Flexible Schedules (select positions)
- Fewer Shifts Cancelled
- Weekly pay
- 403(b) Pre-tax retirement
- Employee Assistance Program
- Employee wellness program
- Discount Entertainment tickets
- Restaurant/Shopping discounts
- Auto Purchase Plan
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysismedical record auditscompliance assessmentCorrective Action Plansclinical findings documentationaudit tool developmentattention to detailHEDIS specificationsproblem solvinginvestigative skills
Soft skills
verbal communicationwritten communicationcollaborative skillsleadership skillsconfidentialityprioritizationcreativitygoal orientationaccuracyindependence
Certifications
LPN license