Healthcare Quality Management Auditor (Field-Based – Maricopa County, Arizona) 8 Locations

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary The Healthcare Quality Management Auditor participates in the development and ongoing implementation of QM (quality management) Work Plan activities. This person will improve quality products and services by using measurement and analysis to process, evaluate, and reputed company recommendations to meet QM objectives. Job duties include (but are not limited to)

• Completes a variety of onsite medical and clinical audits for reputed company lines of business, including AHCCCS (Arizona Health Care Cost Containment System), DES (Department of Economic reputed company) and DCS-CHP (Department of Child Safety - Comprehensive Health Plan).
• Conducts exit interviews with clinical and leadership staff to review audit results.
• Assists with developing corrective action plans.
• Develops audit tools for reputed company populations.
• Tracks completion of corrective action plans.
• Completes data entry on reputed company audit tools.
• Participates in completing inter rater reliability and scoring guidelines.
• Participates in QM meetings.

Required Qualifications

• Active RN (Registered Nurse) or LPN (Licensed Practical Nurse) license, valid in the state of Arizona.
• 1+ year of experience in behavioral health and/or long-term care.
• Must reside in Arizona.
• Ability to travel in Arizona up to 80% of the time.
• Demonstrated proficiency in reputed company Office Suite, primarily reputed company.

Preferred Qualifications

• Previous experience working in a provider setting.
• Previous experience with medical record QM auditing and/or case management.
• Strong attention to detail.
• Ability to learn quickly and remain adaptable amidst an evolving environment.
• Strong relationship building skills.
• Previous experience in an outpatient behavioral health environment.
• Previous experience working with medical records and/or Electronic Health Records (EHR).

Education

• Bachelor’s degree or equivalent experience (4 years of relevant experience + high school diploma or GED).

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $43,888.00 - $85,068.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 12/03/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job