Compliance Audit Nurse

Become a part of our caring community

The Compliance Audit Nurse is responsible for auditing care management activities and documentation to ensure adherence to policies, procedures, and regulations. The Compliance Audit Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Compliance Audit Nurse ensures mandatory reporting completed. Conduct and summarize compliance audits. Collect and analyze data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Follow established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

• Bachelor's degree in Nursing
• Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies
• 3+ years clinical nursing experience
• 1+ years Prior Compliance Auditing experience in healthcare
• Proficient with Microsoft Office products including Word, Excel and Outlook
• Must reside in the state of Oklahoma

Preferred Qualifications

• Previous Medicare/Medicaid experience
• Previous experience in utilization management, case management, discharge planning and/or home health or rehab
• Certification in Case Management a plus (CCM)

Additional Information

Workstyle – Remote work at Home with the ability to travel to the office for meetings and trainings as needed.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,100 - $97,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Originally posted on Himalayas