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Clinical Services Auditor

Employer
Arkos Health
Location
Fargo
Salary
60000.00 USD Annual

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Job Description:

The position of Clinical Services Auditor reports directly to the Vice President of Clinical Services and provides day-to-day tracking, monitoring and adherence to all standards and expectations of the clinical services programs. This position has regular contact through electronic communications (MS Teams, email, zoom) to all directorial staff and VP of Clinical Services. In office meetings as required by leadership teams.

The Company:

Arkos Health is a new kind of healthcare company that serves health plans and provider organizations an integrated system-of-care comprised of clinical and social services backed by a robust technology platform. By engaging individuals with virtual, in-home, in-clinic and in-facility care options, Arkos Health delivers advanced community-based health services that allow our clients to live healthier, more independent lives.

All Employee MUST be fully COVID-19 Vaccinated.

Essential Duties and Responsibilities:

Responsible for auditing all daily logs maintained by clinical services team for timely and accurate use.
Coordinate all log auditing information with applicable service line director for appropriate staff training and feedback.
Perform daily audits for TCM/MRP completion to insure contractual adherence and report issues to appropriate leadership.
Weekly scheduled performance monitoring of calls and auditing of call reports (Five9) to identify any productivity, efficacy, process improvement or training opportunities for clinical services teams.
Communicate auditing results for training and quality improvement opportunities to appropriate directors and VP of Clinical Services through weekly reporting of identified areas of concern.
Prepare and appropriately deliver all transitional and post-acute program metric results monthly to Director and VP of Clinical Services.
Perform audit of all clinical services programs for accurate reporting of clinical metrics.
Verify and reconcile any discrepancies in member data eligibility for services and enter/remove from systems as appropriate.
Perform back up to ED Care Coordination and Skilled Nursing Facility liaison team as needed.

Qualifications/Skills:

Current, unrestricted Nursing license.
Ability to present clinical information both accurately and confidently.
Ability to communicate effectively and in a professional manner with all levels of internal staff and external customers.
Ability to be detail-oriented, able to function under pressure and able to prioritize and reprioritize tasks as needed.
Ability to work both independently and as part of a team, with minimal supervision.
Excellent customer service and communication skills, both oral and written.
Knowledge of Medicare, state, and local managed care regulations, prior experience in Managed Care setting preferred.
Five years acute care, care management experience, or other relevant clinical role requiring quick critical thinking experience preferred.

Benefits:

Fully paid employee medical/dental/vision/life/short term disability
Employer matching 401(k)
15 days annual combined sick/PTO with 9 paid holidays

Must complete our Culture Index Survey. Take the assessment at This is not a pass/fail test and does not measure intelligence.

Arkos Health EEO Statement

All Arkos Health divisions are Equal Opportunity Employers. We do not discriminate on the basis of race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or any other status protected under federal, state or local laws.

Arkos Health is a drug free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.

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