RN Auditing Training Specialist - La Palma, CA

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Clinical Services Auditing and Training Specialist is an experienced clinician that will act as a teacher and mentor to other clinical staff.

Primary Responsibilities:

  • This position provides education and coaching on patient assessment, patient care, and computer documentation

  • Perform regular audits of all disciplines and provide feedback and opportunities identified to the Senior Director of Clinical Services

  • Review detailed clinical information, analyze and interpret clinical documentation, determine relevance, and make clinically sound conclusions

  • Responsible for the development and maintenance of all training materials and job aids and serves as subject matter expert

  • Reviews the work of others and identifies opportunities

  • Clinical Interface/liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification)

Required Qualifications:

  • Current and unrestricted California RN license

  • 2+ years of clinical nursing experience

  • 3 years of UM experience in a managed care setting, preferable case manager

  • Managed care experience

  • Proficient in Microsoft Word, Excel, Powerpoint

Preferred Requirements:

  • BSN

  • 5 years of clinical nursing experience

  • Experience with audits

  • Experience with teaching/coaching

AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: RN, clinical nurse, UM, managed care, case manager, audits, teacher, coach, excel, quality, La Palma, Anaheim, Fullerton, Lakewood, Long Beach, CA


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