Quality Auditor - Remote | Wfh

As a Quality Auditor, you will have a critical role in upholding the quality of our healthcare services. You will work closely with our MRT, consisting of nurse Case Managers and Medical Directors, to ensure adherence to standard operating procedures (SOPs) and enhance overall quality and efficiency.
Key Responsibilities
Conduct proactive case audits, review peer feedback, and assess ad hoc evaluation modules to ensure high-quality clinical activities.
Collaborate with MRT Supervisors and Manager to address individual and team needs, identifying themes for improvement.
Provide oversight for the QA committee, including scheduling and documenting meetings in compliance with industry requirements, reporting on metrics, and tracking trends.
Maintain comprehensive reference materials (SOPs) in collaboration with the team and management.
Collaborate with the team and management to address external process, QA, and timeline inquiries as needed.
Monitor relevant GSC (Global Service Center) QA issues and liaise with GSC management for feedback.
Participate in the revision and maintenance of audit tools and productivity models, working closely with the Business Analyst.
Perform other duties as assigned.
Requirements
Current and active RN license, specifically a PA license, with approximately five years of clinical experience.
Preferred Previous Experience In QA/PI.
Minimum of 3 years of experience in a medical case management environment.
Knowledge of US managed care and experience in managing care internationally.
Detail-oriented with effective interpersonal skills and a team-oriented mindset.
Ability to independently research medical standard of care protocols across multiple resources.
Strong time management and organizational skills.
Basic computer skills, including proficiency in Excel, including report functions.
High energy level with excellent written and oral communication skills.
Minimum internet speed of 75 Mbps (standard high-speed internet access).
Working Conditions
Flexibility to work both in an office and remotely from home.
Occasional schedule flexibility may be required to attend critical meetings or perform essential job functions outside regular working hours.
Physical Demands: Effective communication through auditory and visual means is essential.
Salary: $ 75,926.00 96,806.00 Per Year