Quality Audit Nurse

Our client is currently seeking a Remote Quality Auditor Nurse! This is a contract role, running through January 2026 Candidates must live in NJ, PA, NY, CT, or MD Mon-Fri business hours Equipment provided!

Audit Clinical Documentation: Review medical records and documentation to ensure accuracy, completeness, and compliance with regulatory standards. HEDIS & CMS Compliance: Conduct audits aligned with HEDIS measures and CMS-CAPs (Corrective Action Plans) to evaluate adherence to Medicare and Medicaid requirements. Data Analysis & Reporting: Analyze audit results, identify error trends, and prepare reports for internal teams and leadership. Process Improvement: Recommend changes to workflows or documentation practices to improve quality and compliance. Collaboration: Work closely with clinical teams, quality improvement staff, and business unit directors to ensure audit findings are addressed and improvements are implemented.