Tampa, FL · On-site
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... Meets minimum production standards related to clinical auditing. May conduct staff trainings as ...
Tampa, FL · On-site
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... Meets minimum production standards related to clinical auditing. May conduct staff trainings as ...
$26 - $29.50/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$26 - $29.50/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
Hopewell, NJ · On-site +1
$79K - $105K/yr
About the Role Health Affairs - Quality Management - Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory ...
Hopewell, NJ · On-site +1
$79K - $105K/yr
About the Role Health Affairs - Quality Management - Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory ...
Jacksonville, FL · On-site
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... Meets minimum production standards related to clinical auditing. May conduct staff trainings as ...
Jacksonville, FL · On-site
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... Meets minimum production standards related to clinical auditing. May conduct staff trainings as ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
The Clinical Quality Coordinator will collaborate with leadership to maintain survey readiness ... Develop and maintain proficiency in the functionality and auditing within electronic platforms such ...
The Clinical Quality Coordinator will collaborate with leadership to maintain survey readiness ... Develop and maintain proficiency in the functionality and auditing within electronic platforms such ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$26 - $29.50/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$26 - $29.50/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$29.05 - $56.64/hr
Contributes to overarching strategy to provide quality and cost-effective member care. Essential ... related to clinical auditing. • May conduct staff trainings as needed. • Communicates with ...
$24.50 - $27.75/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$24.50 - $27.75/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$24.50 - $27.75/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
$24.50 - $27.75/hr
At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in ... Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and ...
Huntington Beach, CA · On-site
$126K - $138K/yr
... Auditor to plan, execute, and report on internal quality system audits in accordance with ISO 13485 ... Support IDE compliance activities under 21 CFR Part 812 as needed, including clinical device ...
Quick apply
Huntington Beach, CA · On-site
$126K - $138K/yr
... Auditor to plan, execute, and report on internal quality system audits in accordance with ISO 13485 ... Support IDE compliance activities under 21 CFR Part 812 as needed, including clinical device ...
Huntington Beach, CA · On-site
$126K - $138K/yr
... Auditor to plan, execute, and report on internal quality system audits in accordance with ISO 13485 ... Support IDE compliance activities under 21 CFR Part 812 as needed, including clinical device ...
Huntington Beach, CA · On-site
$126K - $138K/yr
... Auditor to plan, execute, and report on internal quality system audits in accordance with ISO 13485 ... Support IDE compliance activities under 21 CFR Part 812 as needed, including clinical device ...
$37.25 - $49.75/hr
Under the supervision of the Director of Quality Assurance, the Clinical Quality Assurance Specialist will be responsible for the oversight of internal and external contract auditing and ...
$37.25 - $49.75/hr
Under the supervision of the Director of Quality Assurance, the Clinical Quality Assurance Specialist will be responsible for the oversight of internal and external contract auditing and ...
Performs a detailed quality assurance of claims processed by the Third-Party Administrator (TPA ... Coordinates with the Nurse Auditor for clinical consultations or account referrals when necessary.
Performs a detailed quality assurance of claims processed by the Third-Party Administrator (TPA ... Coordinates with the Nurse Auditor for clinical consultations or account referrals when necessary.
$204K - $246K/yr
Position We are seeking an experienced and dynamic Director, Auditor, Clinical Quality Assurance to lead our GCP auditing efforts. The successful candidate will play a pivotal role in ensuring that ...
$204K - $246K/yr
Position We are seeking an experienced and dynamic Director, Auditor, Clinical Quality Assurance to lead our GCP auditing efforts. The successful candidate will play a pivotal role in ensuring that ...
Orange, CT · On-site
$39 - $52.25/hr
The Quality Auditor & QAPI Data Specialist supports the organization's Quality Assessment and Performance Improvement (QAPI) program through clinical auditing, quality data management, regulatory ...
Orange, CT · On-site
$39 - $52.25/hr
The Quality Auditor & QAPI Data Specialist supports the organization's Quality Assessment and Performance Improvement (QAPI) program through clinical auditing, quality data management, regulatory ...
$17.24 is the 25th percentile. Wages below this are outliers.
$12.74 - $24.61
66% of jobs
$30.71 is the 75th percentile. Wages above this are outliers.
$24.61 - $36.47
18% of jobs
$36.47 - $48.34
6% of jobs
$48.34 - $60.21
2% of jobs
$60.21 - $72.07
1% of jobs
$72.07 - $83.94
0% of jobs
$83.94 - $95.80
0% of jobs
$95.80 - $107.67
0% of jobs
$107.67 - $119.54
0% of jobs
$119.54 - $131.40
3% of jobs
$131.40 - $143.27
4% of jobs
$12
$38
$143
A Clinical Quality Auditor is responsible for evaluating and ensuring compliance with regulatory standards, company policies, and clinical best practices in healthcare or pharmaceutical settings. They conduct audits of clinical trials, healthcare procedures, or documentation to identify areas for improvement and ensure patient safety. Their role involves reviewing protocols, analyzing data, and providing recommendations to maintain high-quality standards in clinical operations.
A Clinical Quality Auditor typically requires a background in healthcare, clinical research, or nursing, along with knowledge of regulatory guidelines such as GCP, FDA, or ISO standards. Familiarity with audit management software, electronic medical records (EMR), and certification such as Certified Clinical Research Professional (CCRP) or similar is highly valuable. Strong attention to detail, analytical thinking, communication, and problem-solving skills set exceptional auditors apart. Mastery of these skills ensures thorough audits, regulatory compliance, and the maintenance of high clinical quality standards.
Clinical Quality Auditors often encounter challenges such as keeping up-to-date with constantly evolving regulatory requirements and ensuring compliance across diverse clinical settings. They may also need to manage large volumes of complex data and documentation while navigating tight deadlines. Working collaboratively with multiple departments and communicating findings diplomatically are crucial parts of the job. These challenges make the role dynamic and provide valuable opportunities to develop expertise in clinical quality assurance.
Cities with the most Clinical Quality Auditor job openings:
The most popular types of Clinical Quality Auditor jobs are:
States with the most job openings for Clinical Quality Auditor jobs include:
The top searched job categories for Clinical Quality Auditor jobs are:
$29.05 - $56.64/hr
Full-time
Re-posted 21 days ago
8.0
Based on 199 frontline employees who took The Breakroom Quiz
166th of 311 rated insurance
JOB DESCRIPTION Job Summary
Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
Adheres to departmental standards, policies and protocols.
Maintains detailed records of auditing results.
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards related to clinical auditing.
May conduct staff trainings as needed. Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and restricted in state of practice.
Strong attention to detail and organizational skills.
Strong analytical and problem-solving skills.
Ability to work in a cross-functional, professional environment.
Ability to work on a team and independently.
Excellent verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
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To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $29.05 - $56.64 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980
