St. Paul's Senior Services
Overview
St. Paul\u2019s PACE Corp, 3444 Camino Del Rio North, San Diego, California, United States of America. San Diego\u2019s St. Paul\u2019s PACE program (Program of All-Inclusive Care for the Elderly) provides coordinated medical care to individuals 55 years or older with chronic illness or disabilities, to help them remain independent at home and in the community. The healthcare teams coordinate medical, social, and home care services so individuals do not need to manage their medical care alone. Job Description
Posted Monday, December 1, 2025 at 8:00 AM. The Nurse Auditor is responsible for conducting ongoing audits, monitoring, and data analysis to comply with local, state, and federal regulations and established nursing standards and best practices. This role involves developing, implementing, and evaluating quality improvement and compliance initiatives aimed at enhancing patient outcomes and ensuring safety and high-quality care. The Nurse Auditor collaborates with interdisciplinary teams and non-clinical staff to maintain high standards of care and support for the elderly. Responsibilities
Using clinical experience and expertise, conduct routine and complex compliance audit activities (e.g., reviewing medical records, conducting walkthroughs), document and analyze results, and propose recommendations for improvement of internal departments and external partners. Audit patient records for completeness, consistency, and appropriateness of care. Identify discrepancies and provide feedback to clinical and non-clinical staff for correction. Analyze trends and patterns in documentation to identify areas for improvement. Collaborate with nursing leaders to develop and implement strategies for enhancing quality of care. Participate in quality improvement and compliance initiatives and committees. Develop audit materials and processes to maintain appropriate auditing practices based on CMS and DHCS requirements. Write accurate and high-quality audit reports using clinical knowledge to determine findings. Proactively identify support opportunities surrounding health and safety, clinical compliance, and quality improvement. Comply with HIPAA, privacy, and confidentiality laws and regulations. Other duties as assigned. Qualifications and Requirements
Requires an active and unrestricted CA RN license. Must be a graduate of an accredited school of nursing. BSN preferred, but ADN will be considered. Certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Inpatient Coder (CIC) can be advantageous. Experience
Minimum of one year\u2019s experience working with the frail or elderly. Minimum of three years of hands-on clinical experience or experience in case management preferred. One to three years of relevant quality, compliance, and/or auditing experience in PACE or aging services compliance highly desirable. Skills and Knowledge
Attention to detail and excellent analytical skills. Excellent written and verbal communication skills and interpersonal abilities. Ability to work independently and as part of a team and prioritize tasks. Proficiency in using electronic medical records and other healthcare software. Understanding of quality improvement concepts and LEAN methodology. Strong knowledge of DHCS, CMS, and/or NCQA requirements and an understanding of clinical audit and documentation standards. Ability to facilitate effective meetings. Reports to
Quality and Compliance Manager. Benefits
Flexible Vacation Time - 17 days Paid Sick Time Education reimbursement - up to $3,000 a year Qualified Public Student Loan Forgiveness (PSLF) employer 403(b) with match Child care available Upward mobility You Make Us Who We Are! St. Paul\u2019s Senior Services is an Equal Opportunity Employer. St. Paul\u2019s PACE Corp, 3444 Camino Del Rio North, San Diego, California, United States of America.
#J-18808-Ljbffr
St. Paul\u2019s PACE Corp, 3444 Camino Del Rio North, San Diego, California, United States of America. San Diego\u2019s St. Paul\u2019s PACE program (Program of All-Inclusive Care for the Elderly) provides coordinated medical care to individuals 55 years or older with chronic illness or disabilities, to help them remain independent at home and in the community. The healthcare teams coordinate medical, social, and home care services so individuals do not need to manage their medical care alone. Job Description
Posted Monday, December 1, 2025 at 8:00 AM. The Nurse Auditor is responsible for conducting ongoing audits, monitoring, and data analysis to comply with local, state, and federal regulations and established nursing standards and best practices. This role involves developing, implementing, and evaluating quality improvement and compliance initiatives aimed at enhancing patient outcomes and ensuring safety and high-quality care. The Nurse Auditor collaborates with interdisciplinary teams and non-clinical staff to maintain high standards of care and support for the elderly. Responsibilities
Using clinical experience and expertise, conduct routine and complex compliance audit activities (e.g., reviewing medical records, conducting walkthroughs), document and analyze results, and propose recommendations for improvement of internal departments and external partners. Audit patient records for completeness, consistency, and appropriateness of care. Identify discrepancies and provide feedback to clinical and non-clinical staff for correction. Analyze trends and patterns in documentation to identify areas for improvement. Collaborate with nursing leaders to develop and implement strategies for enhancing quality of care. Participate in quality improvement and compliance initiatives and committees. Develop audit materials and processes to maintain appropriate auditing practices based on CMS and DHCS requirements. Write accurate and high-quality audit reports using clinical knowledge to determine findings. Proactively identify support opportunities surrounding health and safety, clinical compliance, and quality improvement. Comply with HIPAA, privacy, and confidentiality laws and regulations. Other duties as assigned. Qualifications and Requirements
Requires an active and unrestricted CA RN license. Must be a graduate of an accredited school of nursing. BSN preferred, but ADN will be considered. Certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Inpatient Coder (CIC) can be advantageous. Experience
Minimum of one year\u2019s experience working with the frail or elderly. Minimum of three years of hands-on clinical experience or experience in case management preferred. One to three years of relevant quality, compliance, and/or auditing experience in PACE or aging services compliance highly desirable. Skills and Knowledge
Attention to detail and excellent analytical skills. Excellent written and verbal communication skills and interpersonal abilities. Ability to work independently and as part of a team and prioritize tasks. Proficiency in using electronic medical records and other healthcare software. Understanding of quality improvement concepts and LEAN methodology. Strong knowledge of DHCS, CMS, and/or NCQA requirements and an understanding of clinical audit and documentation standards. Ability to facilitate effective meetings. Reports to
Quality and Compliance Manager. Benefits
Flexible Vacation Time - 17 days Paid Sick Time Education reimbursement - up to $3,000 a year Qualified Public Student Loan Forgiveness (PSLF) employer 403(b) with match Child care available Upward mobility You Make Us Who We Are! St. Paul\u2019s Senior Services is an Equal Opportunity Employer. St. Paul\u2019s PACE Corp, 3444 Camino Del Rio North, San Diego, California, United States of America.
#J-18808-Ljbffr