Quality Auditor/Reviewer Clinician - Hybrid position

Job Description:This is a hybrid position open only to residents of the Louisville Metro areaESSENTIAL JOB FUNCTIONS- Conducts routine reviews of clinical records for quality, medical necessity and compliance with licensure, state and federal guidelines, payer guidelines and evidence-based practices.- Interacts with staff and managers to provide consultation, feedback, and ongoing education.- Provides quality improvement consultation related to quality of care and utilization review.- Reviews data and trends to identify and coordinate improvement activities.- Partners with divisions to ensure compliance with quality and compliance initiatives and requirements.- Keeps abreast of current rules, regulations, policies and procedures applicable to initiatives including documentation requirements.- Conducts compliance investigations as needed and appropriate.- Participates in compliance and quality audits and provides support for monitoring audits.- Monitors DCO's (Designated Collaborating Organization) through program reviews and implements, trains, and provides oversight of DCO contract deliverables, as appropriate.- Develops and maintain updates of training for staff to implement process changes and improve performance.- Facilitates trainings aligned to organization needs for specific training content, that may include becoming a

Created: 2026-02-23