Clinical Quality Auditor, Nurse Practitioner

Responsibilities

• 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.

Requirements

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

Benefits

Additional Information

How You'll Make An Impact At Strive Health, patients come first. We're on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You'll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you're looking for meaningful work where your contributions truly matter, you'll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility - Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support - Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources. Time Off & Leave - Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves. Wellness & Growth - Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend. To learn more about our offerings, click here .

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