Clinical Nurse Reviewer – STAR Kids Audit Oversight

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🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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CVS Health Careers

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10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Lead the coordination and execution of monthly rolling STAR Kids state audit submissions • Pull, merge, and organize required documentation from multiple sources to meet state audit requirements • Prepare documents, including formatting and bookmarking, in compliance with state standards • Track submission timelines, ensure deadlines are met, and maintain audit documentation logs • Serve as the subject matter expert for STAR Kids audit processes, providing guidance and updates to internal teams • Conduct comprehensive monthly reviews of STAR Kids service coordination charts for documentation compliance and audit readiness • Identify documentation gaps, compliance risks, and trends across service coordination records • Provide written risk analysis reports and develop targeted recommendations for quality improvement • Collaborate with service coordination supervisors and quality teams to implement corrective actions and process improvements • Maintain audit readiness month-over-month by developing proactive risk-reduction strategies

🎯 Requirements

• Active and Unrestricted Texas or Compact RN Licensure • 2 Years STAR Kids MDCP Experience • Must reside in Texas • Previous auditing experience (preferred) • Associate Degree in Nursing

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility in addition to base pay

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