Health Plans Licensed Practical Nurse LPN Auditor - Phoenix

Job Summary

This position coordinates and performs quality medical record reviews of the ambulatory medical record for PCP's, OBGYN and High Volume Specialists (HVS).

This position is also responsible for assisting the QM RN with the investigation and research of quality of care concerns that have been referred to the Quality Management Department for review and resolution.

Responsibilities

• Assists in the development of clinical medical record audit tools and processes.
• Conducts data analysis using Microsoft Excel; Requests, compiles, sorts, prepares, reviews validates analyzes data extracted from , TCS Medical records survey tools using statistically reliable sampling methods.
• Coodinates retrieves retrieves Medical record audits determine provider compliance established AHCCCS standards documentation conjunction re-credentialing process.

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Job description

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