Auditor, Clinical Services
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
$29.05 - $56.64/hr
Job Summary Provides support for healthcare services clinical auditing activities. Performs audits ... Employment Type: Full Time
New York, NY · Remote
$55K - $99K/yr
Clinical Coding Auditor & Trainer Remote Position Location: New York Permanent Pay Rate: USD $60K/yr - $90K/yr + Benefits Position Purpose: Responsible for developing and conducting training and ...
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New York, NY · Remote
$55K - $99K/yr
Clinical Coding Auditor & Trainer Remote Position Location: New York Permanent Pay Rate: USD $60K/yr - $90K/yr + Benefits Position Purpose: Responsible for developing and conducting training and ...
South San Francisco, CA · On-site
$60 - $75/hr
... Full-time, M-F 8am-5pm Contract-to-hire We are seeking a GxP Auditor to join a quality team in a ... Plan and conduct GxP audits (primarily GMP), including vendor and clinical/investigator site audits
South San Francisco, CA · On-site
$60 - $75/hr
... Full-time, M-F 8am-5pm Contract-to-hire We are seeking a GxP Auditor to join a quality team in a ... Plan and conduct GxP audits (primarily GMP), including vendor and clinical/investigator site audits
Atlanta, GA · On-site
Clinical Nurse Auditor Category: Analytics and Emerging Digital Technologies Main location: United ... J0726-2198 Employment Type: Full Time Position Description: CGI is one of the world's largest ...
Atlanta, GA · On-site
Clinical Nurse Auditor Category: Analytics and Emerging Digital Technologies Main location: United ... J0726-2198 Employment Type: Full Time Position Description: CGI is one of the world's largest ...
Rock Hill, SC · On-site
$40K - $58K/yr
We are looking to invite two full-time passionate and dedicated full-time Clinical Counselor to ... Review Auditor when requested. 8. Remains current by attending Safety Trainings, mandatory ...
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Rock Hill, SC · On-site
$40K - $58K/yr
We are looking to invite two full-time passionate and dedicated full-time Clinical Counselor to ... Review Auditor when requested. 8. Remains current by attending Safety Trainings, mandatory ...
Indianapolis, IN · On-site
$86K - $129K/yr
Patient Safety DRG Clinical Validation Auditor Location ... This role enables associates to work virtually full-time, except for required in-person training ...
Indianapolis, IN · On-site
$86K - $129K/yr
Patient Safety DRG Clinical Validation Auditor Location ... This role enables associates to work virtually full-time, except for required in-person training ...
Washington, DC · Remote
$95K - $105K/yr
DRG Coder, Registered Nurse 📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding About the Role We are seeking an experienced DRG Coder / Clinical Auditor (RN) to conduct ...
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Washington, DC · Remote
$95K - $105K/yr
DRG Coder, Registered Nurse 📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding About the Role We are seeking an experienced DRG Coder / Clinical Auditor (RN) to conduct ...
Indianapolis, IN · On-site
$86K - $129K/yr
Patient Safety DRG Clinical Validation Auditor Location ... This role enables associates to work virtually full-time, except for required in-person training ...
Indianapolis, IN · On-site
$86K - $129K/yr
Patient Safety DRG Clinical Validation Auditor Location ... This role enables associates to work virtually full-time, except for required in-person training ...
Glendale, CA · On-site
Adventist Health Glendale is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Glendale, CA · On-site
Adventist Health Glendale is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Artesia, CA · On-site
$600/day
Quality Management (QM) Position Type: Full-time Compensation: $600 per day Location: California (must hold an active CA dental license) Summary The Dental Auditor ensures clinical quality ...
Quick apply
Artesia, CA · On-site
$600/day
Quality Management (QM) Position Type: Full-time Compensation: $600 per day Location: California (must hold an active CA dental license) Summary The Dental Auditor ensures clinical quality ...
Artesia, CA · On-site
$600/day
Quality Management (QM) Position Type: Full-time Compensation: $600 per day Location: California (must hold an active CA dental license) Summary The Dental Auditor ensures clinical quality ...
Quick apply
Artesia, CA · On-site
$600/day
Quality Management (QM) Position Type: Full-time Compensation: $600 per day Location: California (must hold an active CA dental license) Summary The Dental Auditor ensures clinical quality ...
Portland, OR · On-site
$52.55 - $78.77/hr
Adventist Health Portland is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Portland, OR · On-site
$52.55 - $78.77/hr
Adventist Health Portland is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Glendale, CA · On-site
$62.83 - $86.18/hr
Adventist Health Glendale is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Glendale, CA · On-site
$62.83 - $86.18/hr
Adventist Health Glendale is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Portland, OR · On-site
Adventist Health Portland is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Portland, OR · On-site
Adventist Health Portland is looking for Chart Auditor for Full-time, Day Shift. We are looking for ... Focuses on clinical denials, observation services, documentation gaps, and payer requirements for ...
Indianapolis, IN · On-site
$86K - $129K/yr
This role enables associates to work virtually full-time, except for required in-person training ... The Patient Safety DRG Clinical Validation Auditor is responsible for auditing inpatient medical ...
Indianapolis, IN · On-site
$86K - $129K/yr
This role enables associates to work virtually full-time, except for required in-person training ... The Patient Safety DRG Clinical Validation Auditor is responsible for auditing inpatient medical ...
$38.5K - $48.7K
3% of jobs
$48.7K - $59K
11% of jobs
$59K - $69.2K
8% of jobs
$72.5K is the 25th percentile. Wages below this are outliers.
$69.2K - $79.4K
11% of jobs
The median wage is $88.3K / yr.
$79.4K - $89.6K
20% of jobs
$89.6K - $99.9K
13% of jobs
$108K is the 75th percentile. Wages above this are outliers.
$99.9K - $110.1K
12% of jobs
$110.1K - $120.3K
11% of jobs
$120.3K - $130.5K
9% of jobs
$130.5K - $140.8K
3% of jobs
$140.8K - $151K
0% of jobs
$38.5K
$92.8K
$151K
| Aspect | Full Time Clinical Auditor | Part Time Clinical Auditor |
|---|---|---|
| Work Hours | Typically 35-40 hours per week | Fewer hours, usually less than 20 hours per week |
| Certifications | Often requires relevant certifications like Certified Professional Medical Auditor (CPMA) | May require similar certifications but on a part-time basis |
| Work Environment | Full-time employment in healthcare facilities, insurance companies, or consulting firms | Part-time roles in similar settings, often with flexible schedules |
| Job Responsibilities | Comprehensive auditing, compliance checks, and reporting | Focused auditing tasks, supporting full-time auditors |
Full Time Clinical Auditors work standard hours and handle extensive auditing responsibilities, while Part Time Clinical Auditors perform similar tasks with flexible schedules. Both roles require relevant certifications and are found in healthcare and insurance industries, but the full-time position offers more comprehensive engagement.
Cities with the most Full Time Clinical Auditor job openings:
The most popular types of Clinical Auditor jobs are:
States with the most job openings for Full Time Clinical Auditor jobs include:
$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