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LE001 San Juan Regional Medical Center

Clinical Auditor

Career Insights for Clinical Auditor / Utilization Reviewer

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Based on New Mexico data

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What they do

A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.

$96,466 / year median in New Mexico

-8% projected decline

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Job Description

Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.
  • The Clinical Auditor is responsible for abstracting and analyzing data from multiple sources to provide information to the organization which will be used to improve clinical quality.
Required Behaviors:
  • As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values.
These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability, and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.
Required Qualifications:
  • At least 2 (two) years of Acute Care clinical background
  • Registered Nurse (RN)
  • Strong analytical skills
  • Strong organizational skills
  • Exemplary customer service skills
  • Skilled in Microsoft Word and Excel
  • Excellent written and oral communication skills
  • Capacity to work under pressure to meet deadlines in a fast-paced environment
  • Basic understanding of how to locate and interpret evidence-based, scholarly literature
  • Ability to develop a consistent approach to data collections to ensure validity and reliability of data
  • Must be able to prioritize multiple projects, perform complex tasks, organize, and follow through consistently
Preferred Qualifications:
  • Bachelor's degree
  • Basic understanding of Cerner
  • Knowledge of risk management principles to support organization's Quality Management System and
ISO 9001
compliance
Duties and Responsibilities:
  • Perform data analysis
  • Maintain Excel databases
  • Collect and create physician profiles
  • Perform medical chart audits - paper and electronic
  • Collect data and create reports/charts depicting the data
  • Create and run reports from Cerner and related databases
  • Participate on performance improvement teams and committees as needed
  • Support QIEC (e.g., performing data entry, writing follow-up letters on actions, researching cases, etc.)
  • Perform other duties as assigned
  • Each employee is responsible for implementing SJRMC's Service Standards into their daily work:
Safety, Courtesy, Effectiveness, and Stewardship Physical Demands and Environmental Work Conditions:
  • Moderate noise levels
  • Frequent interruptions
  • Primarily office setting with rounding throughout hospital
  • Prolonged sitting, standing, walking, and looking at computer screen
  • Sits, stands, bends, lifts, and moves intermittently throughout the day
  • Must be able to perform quickly and accurately in a busy, stressful environment prioritizing duties
  • Portion of job duties involve the application of manual skills requiring motor coordination in combination with finger dexterity (e.
g., typing on computer keyboard, using a 10-key calculator, etc.) As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission. To learn more, visit us at http://www.sanjuanregional.com.