Top 134 Quality process auditor Jobs in Detroit, Mi

Auditor, Healthcare Services (Remote in MI)
Molina Healthcare —Detroit, MI
- $26.41 - $51.49 an hour
- Full-time
- Remote
- Microsoft Excel
- RN License
- LPC
- Health insurance
Night Auditor-Part Time
PONTCHARTRAIN DETROIT HOTEL LLC —Detroit, MI
- Part-time
- Microsoft Outlook
- Hotel
- High school diploma or GED
- Free parking
- Flexible schedule
Quick Apply
Nurse Auditor, Revenue Integrity - (Remote)
Trinity Health —Livonia, MI
- $325,171 - $487,757 a year
- Full-time
- Remote
- Nursing
- Medication administration
- RN License
Quality Auditor
US Farathane —Sterling Heights, MI
- Mid-level
- High school diploma or GED
- US work authorization
- Paid holidays
- Health insurance
Quick Apply
ASC/Professional Surgical Coding Auditor & Educator (REMOTE)
Trinity Health —Livonia, MI
- Full-time
- Remote
- 5 years
- Analysis skills
- Travel
7d
Quality Auditor – Processes & Warranty Coverage
Expleo —Troy, MI
- Up to $110,000 a year
- 5 years
- Engineering
- Laboratory experience
- Health savings account
- Paid holidays
14d
Corporate Quality Assurance Auditor
ND DEFENSE LLC —Madison Heights, MI
- $90,000 - $100,000 a year
- Full-time
- Mid-level
- 2 years
- Communication skills
Quick Apply
13d
Internal Auditor - Quality
American Rheinmetall —Plymouth, MI
- Background check
- Mid-level
- Associate's degree
Quick Apply
Senior Internal Auditor
Magna International —Troy, MI
- $80,000 - $115,000 a year
- Full-time
- CPA
- Mid-level
- Finance
Quick Apply
Auditor
Contact Government Services, LLC —Detroit, MI
- $50,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Quality System Auditor
Stellantis —Auburn Hills, MI
- 7 years
- Sales
- Engineering
Specialist, Risk and Compliance Services (Center of Excellence)
Deloitte —Detroit, MI
- $63,000 - $116,000 a year
- Full-time
- Microsoft Outlook
- Research
- Mid-level
Quality Auditor - 1st Shift
Barnes Aerospace —Warren, MI
- 5 years
- High school diploma or GED
- Senior level
Quick Apply
Night Audit ("Auditor/a de Turno Nocturno")
AC Detroit at the Bonstelle —Detroit, MI
- Part-time
- Computer literacy
- Writing skills
- Windows
Quick Apply
Sr. Manager/Principal - Audit & Assurance
Everforth, Cybercoders —Detroit, MI
- $150,000 - $200,000 a year
- Extended hours
- CPA
- 5 years
- Office
- Health insurance
- Dental insurance
Quick Apply
5d
Quality Engineer - 2nd Shift
Angstrom-USA, LLC —Taylor, MI
- $45,000 - $52,000 a year
- Full-time
- 5 years
- English
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
Business Management System Representative - IATF / ISO
Fisher Dynamics —Saint Clair Shores, MI
- Full-time
- Background check
- Ability to walk for extended periods
- 5 years
- Health savings account
- Health insurance
Quick Apply
1d
Assistant Director of Weatherization Field Operations
WAYNE-METROPOLITAN COMMUNITY ACTION AGENCY —Highland Park, MI
- $74,000 - $84,000 a year
- Monday to Friday
- Office
- Residential
- 3 years
14d
Advanced Supplier Quality Development Engineer
Venteon —Sterling Heights, MI
- Email
- Engineering
- 3 years
- Travel
- Health insurance
- Dental insurance
Quick Apply
Quality Manager
Garden Fresh Gourmet —Ferndale, MI
- $120,000 - $140,000 a year
- Extended hours
- Background check
- Office
- 3 years
- Health savings account
- Relocation assistance
Quick Apply
6d

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quality process auditor jobs near detroit, mi

Auditor, Healthcare Services (Remote in MI)

Molina Healthcare -
Detroit, MI

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION

This position will offer remote work flexibility, but the selected candidate must reside in Michigan.

Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with Waiver Program is vital to success in this role.

The preferred candidate will have 3 – 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Licensure should be an LPC, RN, LLMSW, LMSW, LBSW.

Hours are Monday – Friday, 8:30AM – 5PM EST.

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
Adheres to departmental standards, policies and protocols.
Maintains detailed records of auditing results.
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards related to clinical auditing.
May conduct staff trainings as needed. • Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.

Required Qualifications

At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.

Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.

Strong attention to detail and organizational skills.

Strong analytical and problem-solving skills.

Ability to work in a cross-functional, professional environment.

Ability to work on a team and independently.• Excellent verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

quality process auditor jobs in detroit, mi

Auditor, Healthcare Services (Remote in MI)

Night Auditor-Part Time

Nurse Auditor, Revenue Integrity - (Remote)

Quality Auditor

ASC/Professional Surgical Coding Auditor & Educator (REMOTE)

Quality Auditor – Processes & Warranty Coverage

Corporate Quality Assurance Auditor

Internal Auditor - Quality

Senior Internal Auditor

Auditor

Quality System Auditor

Specialist, Risk and Compliance Services (Center of Excellence)

Quality Auditor - 1st Shift

Night Audit ("Auditor/a de Turno Nocturno")

Sr. Manager/Principal - Audit & Assurance

Quality Engineer - 2nd Shift

Business Management System Representative - IATF / ISO

Assistant Director of Weatherization Field Operations

Advanced Supplier Quality Development Engineer

Quality Manager

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