Remote LPN Auditor, Clinical Quality Management – Maricopa County, AZ

UnitedHealthcare

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Requisition Number: 2177065
Job Category: Nursing
Primary Location: Phoenix, AZ
(Remote considered)

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

 

This position will be responsible for reviewing Medicaid provider records as they relate to providers who are required to use electronic visit verification.  This position will include reporting to AHCCCS on audit results or other inquiries.

 

This position is a work from home position with 50% in state travel. 

 

If you are located in Arizona, you will have the flexibility to work remotely* as you take on some tough challenges. Must reside to Arizona.

 

Primary Responsibilities:

  • Review and audit Medicaid (AHCCCS) providers and medical records regarding AHCCCS AMPM requirements
  • Monitor the production of quality results reporting; analyze, track and trend the reporting results and assess need for corrective action plans and follow up
  • Recommend, develop, and implement quality improvement plans with providers and follow up as necessary
  • Prepare for and participate in meetings with State agencies, providers, and stakeholders as well as internal meetings
  • This position will have on site provider location visits throughout Arizona
  • Assist with other quality management audits, corrective action plans as needed

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Active and unrestricted LPN license in AZ
  • 3+ years of experience in the Medicaid health field including provider interactions
  • 2+ years of experience reviewing medical record charts/documentation and writing regulatory reports
  • Proficiency in software applications that include, but are not limited to, Microsoft Word, Excel and Teams
  • Must reside in AZ
  • Reliable transportation for field visits

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy