More jobs:
Texas Licensed Clinical Investigator
Job in
El Cajon, San Diego County, California, 92021, USA
Listed on 2026-03-05
Listing for:
Virtual Vocations Inc
Full Time
position Listed on 2026-03-05
Job specializations:
-
Nursing
Healthcare Nursing
Job Description & How to Apply Below
Key Responsibilities:
Identify and conduct clinical audits into suspected fraud, waste, and abuse (FWA) with high autonomy Document findings, including formal reports, graphs, and audit logs Participate in the development and presentation of FWA-related education for teams
Required Qualifications:
Active, unrestricted Registered Nurse (RN) license 3+ years of direct patient care clinical experience; case management experience is a bonus 2+ years of experience in Medical Review, Utilization Management, or Clinical Documentation Improvement Experience conducting forensic medical audits related to clinical narrative and coding validation Bonus points for relevant degrees or certifications in nursing and healthcare fraud investigation
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