Temp Associate, Care Management Internal Audit
Job Closed
Company
We are the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most. Founded in 2017 on the premise of local health, we are backed by some of the top healthcare investors in the country. Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams. In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.
Overview
Required skills and experience: •Registered Nurse, or Social Worker with current and active license. •2 years of experience in clinical auditing such as case management, HEDIS, or compliance. •2 years of experience in NCQA, URAC, and/or CMS regulations •2 years of experience in Case Management •Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems. •Strong understanding in Medicaid and Medicare requirements across multiple states Nice to Have: •Prior experience working in a start-up setting •Prior experience working with Google products •CCM or CPHQ certification What you need to know: •Seeking a Temp Associate, Care Management Auditing to help manage our case management documentation compliance. You’ll work closely with our care team members, care team leads, Quality team, and Market Operations team. Location: Remote * Will consider any candidate in the US as long as they have the required skills/background and an active RN or LCSW license. Schedule: •Hours: M-F, 9am-5pm