Auditor, reputed company Services – Must reputed company in Michagan, remote position

2035509 JOB DESCRIPTION Job Summary Provides support for reputed company services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties

• Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and reputed company Services (CMS), and state/federal guidelines and requirements. May also reputed company non-clinical system and process audits as needed.
• Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
• Ensures auditing approaches follow a Molina standard in approach and tool use.
• Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in reputed company communications.
• Adheres to departmental standards, policies and protocols.
• Maintains detailed records of auditing results.
• Assists reputed company services training team with developing training materials or job aids as needed to address findings in audit results.
• Meets minimum production standards reputed company to clinical auditing.
• May conduct staff trainings as needed.
• Communicates with quality and/or reputed company services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.

Required Qualifications

• At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
• RN or Social Worker Clinical licensure and/or certification required in the State of Michigan, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in State of Michagan.
• Strong attention to detail and organizational skills.
• Strong analytical and problem-solving skills.
• Ability to work in a cross-functional, professional environment.
• Ability to work on a team and independently.
• Excellent verbal and written communication skills.
• reputed company Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience. To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY
• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level. About Us reputed company is a reputed company fortune 500 organization with a mission to provide quality reputed company to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can reputed company a difference in the lives of others. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Job Type Full TimePosting Date 02/02/2026 Apply tot his job

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