Clinical Quality Auditor, Nurse Practitioner - Denver, CO

This role reports to the Sr. Manager, Clinical Quality Performance.

• The Day to Day
• Review clinical documentation and encounters (assessments/surveys, plans of care, recorded encounters) to ensure alignment with clinical guidelines, NCQA standards, and industry best practices.
• Meet auditing productivity targets (daily/weekly/monthly) while maintaining quality assurance standards.
• Validate timeliness and accuracy of internal assessments and plans of care against NCQA Case Management and Population Health requirements.
• Communicate audit findings and provide coaching/education to Kidney Heroes and clinical leaders, clearly documenting deficiencies and improvement opportunities.
• Develop and maintain audit tools and resources by supporting updates to processes, templates, and guidance materials.
• Identify, support resolution, and escalate risks/gaps impacting quality, compliance, safety, or accreditation readiness.
• Flag system or operational barriers that impede attainment of quality performance standards and recommend improvements.
• Accurately abstract and submit audit documentation using designated tools and route required materials to appropriate stakeholders.
• Support compliance and accreditation activities (case prep/review, action plans) while maintaining HIPAA confidentiality and professionalism.

Minimum Qualifications

• Active, unrestricted NP license.
• 6+ years combined of related education, experience, or certification.
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms.
• Ability to travel and be onsite to meet business needs.

Preferred Qualifications

• Application of NCQA program(s) accreditation standards and processes experience.
• Experience in GDMT protocols along with knowledge of proper care of patients with multiple complex medical conditions.
• Familiar with documentation and coding standards for HCC and HEDIS.
• NCQA Accreditation Survey experience or other industry related audits.
• Proficiency in Microsoft Office, Adobe Acrobat and internet/web navigation.
• Case Management Certification.
• Knowledge of the organization of medical records, medical terminology, and disease process.

• About You
• Strong clinical assessment and critical thinking skills.
• Attention to excellence - quality driven, detailed oriented, innovative, and accountable.
• Excellent verbal and written communication skills.
• Ability to work in a team environment.
• Flexibility and strong organizational skills needed.

Annual Base

Salary Range

$99,000 - $124,000. This position is also eligible for a target annual bonus of 10%.

Final compensation will be determined based on location, experience, and qualifications.

• Strive Health is an equal opportunity employer and drug free workplace.
• At this time Strive Health is unable to provide work visa sponsorship.
• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
• Please apply even if you feel you do not meet all qualifications.
• If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com. [talentacquisition@strivehealth.com]

We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.