The Audit Manager reports to the Inspector General within Arizona's Health Care Cost Containment System (AHCCCS) Office of Inspector General and oversees the Quality Assurance Nurse Investigations Unit. This highly skilled registered nurse with utilization review experience provides leadership to staff, conducts complex medical and financial investigations related to healthcare fraud and program mismanagement, and ensures compliance with regulatory standards. The role involves clinical case review, investigative interviews, testimony preparation, and collaboration with executive leadership on strategic initiatives.
Key qualifications:
- Arizona RN License or higher from Arizona Nursing Board
- Five or more years in a hospital setting; three or more years of investigative or audit experience
- Knowledge of Utilization Review and Case Management
- Clinical record review, healthcare data analysis, and investigative techniques
- Leadership, supervision, and staff development capabilities
- Advanced data analysis and medical necessity evaluation skills
Audit Manager in phoenix at Unknown Company
This position is listed as full time and onsite.