Health Management Auditor

Group Health CooperativeAltoona, WI

About The Position

Position Purpose To assist with ensuring documentation compliance and excellence in the Electronic Health Record. Essential Position Functions Review various parts of the member Electronic Health Record focusing on items including, but not limited to, assessments, care plans, correspondence, acuity, and billing to ensure compliance. Review randomly selected member Electronic Health Records to assess critical thinking and proactive case management strategies. Collaborate with Manager of Case Management and Wellness and Health Management Team Leader on training needs identified from audits. Complete special projects as assigned by the Manager of Case Management Lead educational meetings with Case Management staff as directed. Support case management activities and member engagement as needed Assist with NCQA and Metastar audits/duties as assigned. Comply with all company policies and procedures. Group Health Cooperative of Eau Claire complies with applicable Federal civil rights laws and does not discriminate, exclude or treat candidates less favorably on the basis of race, color, national origin (including limited English proficiency and primary language), age, disability, or sex (including sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes). The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard. This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: [email protected]. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.

Requirements

  • Active State of WI Nursing License
  • Case Management Experience
  • Proficient in the use of Microsoft Word and Excel
  • Excellent communication skills
  • Strong attention to detail
  • Good time management and organizational skills required

Responsibilities

  • Review Electronic Health Records for compliance
  • Assess critical thinking and case management strategies
  • Collaborate on training needs
  • Complete special projects
  • Lead educational meetings
  • Support case management activities and member engagement
  • Assist with NCQA and Metastar audits/duties
  • Comply with company policies and procedures

Benefits

  • three weeks of vacation the first year
  • a generous retirement plan
  • health and dental insurance
  • a wellness program
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