Clinical Nurse Reviewer – STAR Kids Audit Oversight

CVS Health

. Lead the coordination and execution of monthly rolling STAR Kids state audit submissions .

Posted 11/5/2026full-timeRemote • Texas • United StatesJuniorMid-Level💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in STAR Kids audit processes, including risk analysis and compliance management. Proficient in documentation organization and quality improvement strategies to ensure audit readiness.

Highest-signal resume keywords

Active Texas RN LicensureSTAR Kids MDCP ExperienceAuditing ExperienceRisk AnalysisQuality Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Documentation OrganizationAudit CoordinationCompliance Risk IdentificationQuality Improvement RecommendationsService Coordination Chart Review

Soft Skills

CollaborationCommunicationAttention to Detail

Certifications & Qualifications

Texas RN Licensure

Industry Keywords

STAR KidsMDCPAudit ReadinessRisk Reduction StrategiesCompliance

About the role

Key responsibilities & impact

Lead the coordination and execution of monthly rolling STAR Kids state audit submissions
Pull, merge, and organize required documentation from multiple sources
Prepare documents through formatting and bookmarking according to state standards
Track submission timelines and maintain audit documentation logs
Serve as the subject matter expert for STAR Kids audit processes
Conduct comprehensive monthly reviews of STAR Kids service coordination charts
Identify documentation gaps, compliance risks, and trends
Provide written risk analysis reports and targeted quality-improvement recommendations
Collaborate with service coordination supervisors and quality teams on corrective actions and process improvements
Maintain month-over-month audit readiness through proactive risk-reduction strategies

Requirements

What you’ll need

Active and Unrestricted Texas or Compact RN Licensure
2 Years STAR Kids MDCP Experience
Must reside in Texas
Associate Degree in Nursing
Preferred: Previous auditing experience

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay