Compliance Audit Nurse

Location: Remote within Oklahoma; occasional travel to hirify.global offices for meetings and training may be required.

Salary: $71,100–$97,800 per year, plus eligibility for a bonus incentive plan.

Company

U.S. healthcare organization providing insurance and healthcare services to individuals, families, Medicare and Medicaid members, military personnel, and communities.

What you will do

• Audit care management activities and documentation for compliance with policies, procedures, and regulations.
• Ensure mandatory reporting is completed accurately and on time.
• Conduct and summarize compliance audits.
• Collect and analyze daily, weekly, monthly, and ad hoc operational and outcome data.
• Interpret guidelines and independently determine appropriate courses of action.
• Connect audit and reporting activities with department, segment, and organizational objectives.

Requirements

• Bachelor’s degree in Nursing.
• Active Registered Nurse license in Oklahoma with no discrepancies.
• 3+ years of clinical nursing experience.
• 1+ year of healthcare compliance auditing experience.
• Proficiency with Microsoft Word, Excel, and Outlook.
• Must reside in Oklahoma and maintain a dedicated, interruption-free workspace to protect PHI and HIPAA information.

Nice to have

• Medicare or Medicaid experience.
• Experience in utilization management, case management, discharge planning, home health, or rehabilitation.
• Case Management certification such as CCM.

Culture & Benefits

• Remote work-from-home arrangement with occasional office travel for meetings and training.
• Self-provided internet service with minimum speeds of 25 Mbps download and 10 Mbps upload.
• Medical, dental, and vision coverage.
• 401(k) retirement savings plan and paid time off, holidays, parental leave, and caregiver leave.
• Short- and long-term disability coverage, life insurance, and additional wellness benefits.