Our Organization:

Come join a company that provides a superb opportunity to learn and advance within healthcare’s most fascinating area of growth! Arkos Health Company, our team delivers advanced, community-based health services to provide quality, patient-focused healthcare. Paired with an integrated system of care comprised of clinical and social services backed by a robust technology platform, our team strives to deliver on our mission to provide advanced, more accessible community-based health services that allow our clients to live healthier, more independent lives.

How You'll Make a Difference:

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.

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 Nevada 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:

• Employer-paid Medical Insurance
• Employer Paid Dental Insurance
• Employer-paid Vision Insurance
• Employer-paid Short-term disability
• Employer-paid life insurance
• Employer matching 401(k)
• 15 days annual combined sick/PTO with 9 paid holidays

Must complete our Culture Index Survey. Take the assessment at https://portal.cultureindex.com/public/survey/general/bg3VS0H2kF. This is not a pass/fail test and does not measure intelligence.

Arkos Health EEO Statement:

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

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.