Nurse Auditor

Job Summary: The Nurse Auditor keeps pace with a progressive and proactive management team and utilizes discretion, independent judgment and critical thinking skills to facilitate initiatives that support the business, clinical, and organizational strategic goals of the LLUH system. Performs medical record audits for Medicare beneficiaries (and others as appropriate) for completeness and compliance with established departmental policies, state, federal and county regulations and requirements set forth in the Medical Staff By-Laws and Rules and Regulations. Applies analytical skills of an experienced registered nurse to measure outcomes and achieve operational and performance excellence. Identifies documentation deficiencies, notifies care givers and provides real-time education as appropriate. Uses concrete analytical methods and produces outcome scorecards. Performs other duties as needed.

Education and Experience: Associate's Degree or Diploma Degree in Nursing required. Bachelor's Degree in Nursing preferred. Minimum one year data analysis experience or case management experience required. Minimum three years experience in case management, utilization review, or internal auditing preferred.

Knowledge and Skills: In-depth knowledge of case management and transitional care practice and methodologies required. Substantial knowledge of basic nursing concepts and care of the patient required. Able to speak, read and write legibly in English with professional quality; use computer, printer, and software programs necessary to the position, e.g., Word, Excel, Outlook, PowerPoint, electronic medical record, electronic event reporting program; relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction; think critically; work independently with minimal supervision; perform basic math and statistical functions; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position; exhibit professional behavior at all times.

Licensures and Certifications: Current California Registered Nurse (RN) license required. Case Management Certification preferred.