Clinical Data Audit Consultant (Healthcare)

Location: Remote in California; Pacific Time Zone work hours. Must maintain a current, valid, and unrestricted California clinical license.

Salary: $33.71–$60.67 per hour

Company

hirify.global connects people to the care they need and works to make healthcare more accessible and effective.

What you will do

• Gather, analyze, and interpret clinical data for service-team tracking, productivity, quality measurement, and regulatory reporting.
• Coordinate internal, external, account, Health Net, NCQA, and URAC audits, including preparing audit cases and supporting quarterly regulatory meetings.
• Document clinical business needs, workflows, policies, procedures, project plans, analytical reports, training plans, and process models.
• Conduct complex trend analysis, investigate regulations, interpret nonconforming data, and develop corrective action plans.
• Work with Data Analysis and other departments to design data pulls, staffing analyses, performance metrics, and management reports.
• Support clinical staff training and supervisors with care-manager audit tracking and operational improvements.

Requirements

• BA/BS in Psychology, Nursing, or a related clinical field.
• Current, valid, and unrestricted California clinical license and/or RN license required.
• Three to five years of case management or related clinical experience.
• Two to three years of experience conducting business studies, recommending solutions, or performing business analysis, preferably in healthcare.
• Experience with clinical data analysis, regulatory requirements, and audit or compliance reporting.

Nice to have

• Master’s degree in Social Work, Counseling, Nursing, or a related field.

Culture & Benefits

• Full-time employment with remote work based in California.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches may include remote, hybrid, field, or office schedules depending on role and eligibility.
• Equal opportunity workplace committed to diversity and fair consideration of qualified applicants.