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Nursing - Quality Auditor Level 2

Careers Integrated Resources Inc Newark, NJ (Onsite) Contractor
Job Title: Nursing - Quality Auditor Level 2
Job Location: Newark, NJ
Job Duration: 6 Months (possibility of extension)
Payrate: $35 - $40/ hr on w2

Job Summary:
  • This position is responsible for conducting quality audits for state audits, HEDIS and quality referral and complaints issues.
  • This position is also responsible for preparing weekly, monthly, quarterly and year-end reports.
Responsibilities:
  • Prepares appropriate documentation to summarize on-site findings with physician, providing education and discussing opportunities for improvement.
  • Provides data support services to facilitate the process and analyze trends/patterns for quality improvement and health management.
  • Assists the Quality Management department with various special projects and focused clinical studies.
  • Performs related tasks or special studies as requested.
  • Assists in training of internal Client staff, providers and vendors on programs and audit standards, both on and off site.
  • In-house representative and project lead for state audits.
  • Responsible for analysis of audit findings.
  • Produces various reports as requested.
  • Co-ordinates and manages the Corrective Action Plan (CAP) process for assigned audit type
  • Conducts reaudits ensuring prior deficiencies were addressed.
Qualifications:
  • Requires three to five years related business experience, preferably n health care industry.
  • Requires License Practical Nurse License or an active New Jersey Registered Nurse License.
Knowledge:
  • Requires knowledge of managed care principles.
  • Requires knowledge of medical terminology.
  • Requires knowledge of PC's and related software.
  • Prefers knowledge of URAC accreditation standards and HEDIS principles.
  • Prefers knowledge of health management or patient education.
Skills and Abilities:
  • Require excellent verbal and written communication skills.
  • Requires excellent organization skills.
  • Require strong analytical skills.
  • Requires good problem solving/conflict resolution skills.
  • Requires good decision making skills.
  • Requires strong PC skills.
  • Require strong presentation skills.
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Job Snapshot

Employee Type

Contractor

Location

Newark, NJ (Onsite)

Job Type

QA - Quality Control

Experience

Not Specified

Date Posted

10/16/2025

Job ID

25-63256

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