Clinical Audit Coordinator

Centene Corporation•St. David's, MI

5d•$23 - $40•Remote

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Remote: Current State’s licensure or Certified Pharmacy Technician (CPhT) preferred Position Purpose: Assist with clinical training programs and audits of clinical systems entry and/or processes. Assists with auditing staff and vendor partners in accordance with established CMS guidelines Partner with business groups to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management Assist with the administration of audit processes and tools related to prior authorizations, appeals, quality improvement, star measurement reviews, inter-rater reliability and data entry Assess training needs and identify, select or develop appropriate training programs including training aids and materials Assist with training staff in the use of audit tools and identification of patterns or trends that require additional training or corrective action Maintain records of training activities and employee progress Participate in Quality and Advisory committees or provider education meetings

Requirements

High school diploma or equivalent.
2+ years of pharmacy technician experience in a managed care or healthcare setting.

Nice To Haves

Audit experience preferred.
Current State’s licensure or Certified Pharmacy Technician (CPhT) preferred

Responsibilities

Assist with clinical training programs and audits of clinical systems entry and/or processes.
Assists with auditing staff and vendor partners in accordance with established CMS guidelines
Partner with business groups to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management
Assist with the administration of audit processes and tools related to prior authorizations, appeals, quality improvement, star measurement reviews, inter-rater reliability and data entry
Assess training needs and identify, select or develop appropriate training programs including training aids and materials
Assist with training staff in the use of audit tools and identification of patterns or trends that require additional training or corrective action
Maintain records of training activities and employee progress
Participate in Quality and Advisory committees or provider education meetings