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WorkdayMedical Management Accreditation & Audit Coordinator – Work From Home
Health Care Service Corporation seeks a Medical Management Accreditation & Audit Coordinator to manage quality improvement initiatives and conduct program audits. This full-time, remote position offers…
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About This Role
Health Care Service Corporation seeks a Medical Management Accreditation & Audit Coordinator to manage quality improvement initiatives and conduct program audits. This full-time, remote position offers a yearly salary between $69,800 and $125,900. The professional in this role will review compliance with accrediting standards and departmental policies, generate management reports, and act as an internal resource for utilization and quality matters. This opportunity is well-suited for independent clinical professionals who…
Job Description
Health Care Service Corporation seeks a Medical Management Accreditation & Audit Coordinator to manage quality improvement initiatives and conduct program audits. This full-time, remote position offers a yearly salary between $69,800 and $125,900. The professional in this role will review compliance with accrediting standards and departmental policies, generate management reports, and act as an internal resource for utilization and quality matters.
This opportunity is well-suited for independent clinical professionals who possess background experience in utilization management, auditing, or case management. Operating hours for the role are Monday through Friday, 8:00 AM to 5:00 CST, with a preference for candidates located near Richardson, Texas.
Health Care Service Corporation operates as an Equal Opportunity Employment employer maintaining a drug-free and smoke-free working environment. Employment may require passing a drug screening.
Responsibilities
- Perform audits and monitor ongoing quality improvement activities within the medical management program
- Evaluate compliance against regulatory requirements, accrediting standards, and departmental policies
- Compile reports for presentations to management, internal committees, and ancillary departments
- Act as a resource for internal ancillary departments regarding utilization and quality topics
- Contribute to accreditation survey procedures
Requirements
- Possess an unrestricted Registered Nurse, Licensed Practical Nurse, or Behavioral Health Professional license in the state of operations
- Minimum of three years of clinical experience, featuring at least two years in utilization review or case management
- Background in quality improvement
- Working familiarity with utilization management and case management policies, practices, and the Medical Management Program
- Analytical capabilities alongside verbal and written communication proficiency
- Familiarity with personal computers and Microsoft Office software
- Ability to function as an independent worker with adequate direction and flexibility for changing responsibilities
- Availability to work Monday through Friday from 8 AM to 5 PM CST
Qualifications
- Bachelor Degree in Nursing, Health Administration, or another healthcare field
- Certified Professional Health Care Quality credential
- Prior background in auditing, utilization management, and health plan operations
Core Skills
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Annual incentive bonus plan eligibility
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, this is a remote role that can be performed from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii, with a preference for candidates in Richardson, Texas.
What is the salary range for this job?
The base pay range is $69,800 to $125,900 per year, with exact compensation varying based on skills, experience, and location. The position also aligns with an annual incentive bonus plan.
What are the required working hours?
The scheduled working hours are 8:00 AM to 5:00 PM CST, Monday through Friday.
What licensure is required to apply?
Applicants must hold an unrestricted license as a Registered Nurse, Licensed Practical Nurse, or Behavioral Health Professional in their state of operations.
Sample Interview Questions
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