LOCATION: This is a field position requiring in-person visits to our providers. When not in the field, you will work remotely. Louisiana residency is required.

HOURS: General business hours, Monday through Friday.

TRAVEL: Travel is required to provider locations in Louisiana.

The Clinical Quality Auditor Sr. is responsible for ensuring clinical quality through an audit process.

Primary duties may include, but are not limited to:

• Conducts on-site audits of prospective and existing physicians and independent practice groups.

• Ensures that both utilization and quality programs meet criteria.

• Collects and analyzes data to formulate recommendations and solutions based on audit trends and results.

• Compiles and maintains statistical data.

• Prepares reports for management that define and evaluate problems and propose solutions.

Required Qualifications

• Current unrestricted RN or LCSW license issued by the state of Louisiana.

• Minimum of 5 years of experience in utilization management, quality assurance and/or plan administration.

• BS in nursing, health sciences, health management or a related clinical field; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

• Behavioral Health experience very strongly preferred.

• Previous auditing experience strongly preferred.

• You must be comfortable providing training to providers and staff related to audit outcomes.