Top 269 Clinical data audit Jobs in Washington, Dc

Clinical Data Audit Consultant
Health Net —Washington, DC
- $33.71 - $60.67 an hour
- Full-time
- Remote
- Nursing
- RN License
- Bachelor of Science
- Paid holidays
- Health insurance
8d
Solutions Architect
RWD Consulting, LLC —Bethesda, MD
- $100,000 - $130,000 a year
- Full-time
- 7 years
- Computer Science
- System design
- Health insurance
- Dental insurance
Quick Apply
Clinical Supervisor (LICSW, LCPC, or LPC)
Peace For DC —Washington, DC
- $60 - $70 an hour
- Part-time
- Hybrid work
- HIPAA
- Mid-level
- 3 years
- Flexible schedule
Quick Apply
Admissions Nurse Manager
MONTGOMERY HOSPICE INC —Rockville, MD
- $90,000 - $100,000 a year
- Full-time
- RN License
- Mid-level
- 3 years
Quick Apply
Registered Nurse (RN) Burn Trauma ICU
MedStar Health —Washington, DC
- $41.37 - $66.92 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Nursing Administrator (RN) Apheresis and Marrow Harvesting Program
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
Director of Development
The Wendt Center for Loss & Healing —Washington, DC
- Full-time
- Hybrid work
- 3 years
- Mentoring
- In-person
- Paid holidays
- Disability insurance
Occupational Therapist Homecare, DC
MedStar Health —Washington, DC
- $72,758 - $130,041 a year
- Full-time
- Computer literacy
- BLS Certification
- Mid-level
Cell Therapy Account Executive
Autolus Inc —Gaithersburg, MD
- $182,000 - $240,000 a year
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
- Health insurance
Quick Apply
Clinical Trial Coordinator
Black Canyon Consulting —Bethesda, MD
- Mid-level
- Training & development
- Paid holidays
- Health insurance
Clinical Research Coordinator
GAP SOLUTIONS INC —Bethesda, MD
- $90,000 - $140,000 a year
- Email
- Nursing
- Mid-level
- Bachelor's degree
Quick Apply
Senior Medical Coder
Optum —Washington, DC
- $24 - $43 an hour
- Full-time
- Remote
- Anatomy knowledge
- Pass drug screening
- Mid-level
CRA 1, IQVIA Biotech
IQVIA —Rockville, MD
- $71,900 - $145,300 a year
- Full-time
- Bachelor's degree
- Travel
- Communication skills
Research Assistant
Inova Health System —Fairfax, VA
- Full-time
- Administrative experience
- Neurology
- Pediatrics
- Wellness program
- Paid parental leave
Clinical Performance Improvement Analyst
VHC Health —Arlington, VA
- $78,582.40 - $143,000.00 a year
- Full-time
- Hospital
- Master's degree
- Analysis skills
- Health insurance
- Dental insurance
3d
Research Project Associate
Inova Health System —Fairfax, VA
- Full-time
- Administrative experience
- Children
- Associate's degree
- Wellness program
- Paid parental leave
Database Administrator
GAP SOLUTIONS INC —Rockville, MD
- $100,000 - $150,000 a year
- Email
- Microsoft Access
- Computer Science
- Mid-level
Quick Apply
Medical Records Technician
RWD Consulting —Silver Spring, MD
- Warehouse
- Entry level
Quick Apply
Compliance Audit / Investigator / Coder - CCS / CPC / or CCA
MedStar Health —Washington, DC
- $65,062 - $117,291 a year
- Full-time
- Microsoft Outlook
- HIPAA
- Research
Certified Medical Coder
Samaritan Healthcare —Washington, DC
- $26.74 - $41.35 an hour
- Full-time
- Remote
- Anatomy knowledge
- Mid-level
- High school diploma or GED
Quick Apply

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Clinical Data Audit Consultant

Health Net -
Washington, DC

Apply Now

Job Details

Full-time
$33.71 - $60.67 an hour
8 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Clinical case management

Full Job Description

Position Purpose: The Clinical Data and Audit Consultant is responsible for the clinical content component of all data collection, account implementations, and audit activities for Clinical Operations to ensure high-quality tracking and performance of the service teams.

Key Details: Registered Nurse - Must be currently licensed in CA. Pacific Time Zone Work Hours

The Consultant gathers and analyzes data, creates workflows, coordinates internal and external audits, and analyzes and documents business processes to meet all clinical, procedural, account, and regulatory requirements.

Demonstrates regular, reliable and predictable attendance.
Leads various data analysis projects to examine and define potential clinically related issues and track productivity and quality measures
Reviews, analyzes, and interprets data for required HEDIS, URAC, NCQA compliance, and related reporting for clinical service teams
Interprets clinical data that does not conform to established/approved, required specifications, including Unity Reports, and assists in corrective action processes
Addresses and participates in training of clinical staff resulting from data tracking and analysis efforts
Identifies, evaluates, recommends and documents clinical business needs and objectives, operational processes and procedures, problems and requirements
Produces documentation, including project plans, analytical reports, decision backup, information research reports, training plans, business justifications, graphics, workflow and business process models
Recommends operational and process improvements based on efficiencies and available technologies
Maintains a repository of performance and audit metrics, and generates management reports illustrating statistical data, text, workflows, and graphics
Conducts secondary research using a variety of publications, services and health statistic databases
May also be assigned lower level management functions and back up supervisors on clinical team
Works with other departments to identify and document business requirements, workflow, policies and procedures
Organizes and compiles cases for all External Health Net, NCQA, URAC, and Account Audits
Participates in Quarterly Health Net Regulatory Audit meetings to assist Clinical Directors
Supports Clinical Supervisors in tracking of monthly Care Manager audit results
Works with Data Analysis Department to design data pulls
Assists with generating HLOC and Outpatient Cost of Care and Target Outlier Reports including trend analysis
Supports staffing analysis with current and forecasted requirements
Investigates current regulations, interprets findings, and makes recommendations to Healthcare Services teams
Conducts complex trend analysis and, based on analysis, creates Corrective Action Plans, and presents recommendations to business teams across department to improve performance

Other duties as required
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:

BA/BS in Psychology, Nursing or other related clinical field; Masters in Social Work, Counseling, Nursing, or related field preferred
Three to five years case management or related clinical experience
Two to three years experience conducting business studies, recommending solutions and/or business analysis, preferably in Healthcare

License/Certification: Licensed Clinician and/or RN required. Must have and maintain current, valid and unrestricted clinical license.

Pay Range: $33.71 - $60.67 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

clinical data audit jobs in washington, dc

Clinical Data Audit Consultant

Solutions Architect

Clinical Supervisor (LICSW, LCPC, or LPC)

Admissions Nurse Manager

Registered Nurse (RN) Burn Trauma ICU

Nursing Administrator (RN) Apheresis and Marrow Harvesting Program

Director of Development

Occupational Therapist Homecare, DC

Cell Therapy Account Executive

Clinical Trial Coordinator

Clinical Research Coordinator

Senior Medical Coder

CRA 1, IQVIA Biotech

Research Assistant

Clinical Performance Improvement Analyst

Research Project Associate

Database Administrator

Medical Records Technician

Compliance Audit / Investigator / Coder - CCS / CPC / or CCA

Certified Medical Coder

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