Auditor UM

Job description

ABOUT THIS POSITION: Plans, designs, develops and performs quality assessments on data elements and structures to document and evaluate integrity, completeness, quality, and appropriateness of formats, records and structures. Configures, operates and develops manual and/or automated methods, processes and procedures to test output or input based on data compliance, quality and use requirements as established by product management, client specifications, and governance programs. Performs regular and ad hoc reviews, audits, and investigations of data activity and integrity; prepares reports and summaries of findings. Produces and updates guidelines and documentation of test development processes, procedures and standards. WHAT YOU'LL DO: Client Education and Success: ● Complete record reviews on client records to identify best practice process improvement opportunities ● Complete data analysis of reviews completed and create summary presentations for internal and external communication of record review results ● Engage with client utilization management teams and provide feedback regarding record review and education associated with identified opportunities for best practice improvem...