Clinical Nurse Reviewer – STAR Kids Audit Oversight

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

📋 Description

• Oversee the organization and implementation of monthly STAR Kids state audit submissions on a rolling basis.

• Extract, consolidate, and arrange necessary documentation from various sources.

• Format and bookmark documents in accordance with state requirements.

• Monitor submission deadlines and maintain logs for audit documentation.

• Act as the expert on STAR Kids audit procedures.

• Perform thorough monthly evaluations of STAR Kids service coordination charts.

• Detect documentation deficiencies, compliance issues, and emerging trends.

• Deliver written risk analysis reports along with targeted recommendations for quality improvement.

• Work in collaboration with service coordination supervisors and quality teams to implement corrective actions and enhance processes.

• Ensure ongoing audit readiness month-over-month through proactive risk mitigation strategies.

⛳️ Requirements

• Active and Unrestricted Texas or Compact RN Licensure.

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

• Must be a resident of Texas.

• Associate Degree in Nursing is required.

• Preferred: Prior experience in auditing.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources for supporting physical, emotional, and financial wellness.

• CVS Health bonus, commission, or short-term incentive program, in addition to base salary.