Clinical Nurse Reviewer – STAR Kids Audit Oversight

This is a fully remote position, open to applicants in Texas.

📋 Description

• Oversee the coordination and implementation of monthly ongoing STAR Kids state audit submissions.

• Extract, consolidate, and organize necessary documentation from various sources to fulfill state audit requirements.

• Prepare documents, ensuring proper formatting and bookmarking, in accordance with state standards.

• Monitor submission timelines, guarantee that deadlines are met, and maintain logs of audit documentation.

• Act as the subject matter expert on STAR Kids audit processes, offering guidance and updates to internal teams.

• Conduct thorough monthly evaluations of STAR Kids service coordination charts to ensure documentation compliance and audit readiness.

• Identify gaps in documentation, compliance risks, and trends within service coordination records.

• Deliver written risk analysis reports and formulate targeted recommendations for quality enhancement.

• Collaborate with service coordination supervisors and quality teams to implement corrective measures and process improvements.

• Ensure ongoing audit readiness by developing proactive strategies to reduce risks month over month.

⛳️ Requirements

• Active and Unrestricted Texas or Compact RN Licensure.

• A minimum of 2 years of STAR Kids MDCP experience.

• Must be a resident of Texas.

• Previous auditing experience is preferred.

• Associate Degree in Nursing.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources that support physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs, in addition to base pay.