[Hiring] Clinical Quality Assurance Auditor @Valued Relationships, Inc.

Remote, USA Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is responsible for proactive Clinical Quality Auditor to support the ongoing monitoring and evaluation of call quality, ensuring compliance with industry regulations, and enhancing the overall customer experience. • Implement audit strategies to assess the quality of calls, compliance with healthcare regulations, and overall adherence to quality standards. • Conduct audits on calls, clinical charts, processes, procedures, and systems to ensure adherence to industry standards. • Process and respond to unresolved escalations, working closely with relevant teams to address issues and provide timely resolutions. • Complete reviews of clinical escalations resulting from outlier biometrics for process and quality recommendations. • Communicate audit findings, analysis, and recommendations to senior management and key stakeholders. • Collaborate with internal teams to identify action plans and implement corrective actions based on audit findings. • Provide coaching and development to team members on job skills, delivery skills, and quality improvement. • Ensure ongoing compliance with quality standards, industry regulations, and internal policies by extracting and evaluating calls. • Analyze call data to identify trends, gaps, and areas for improvement. • Build and maintain strong relationships with internal and external stakeholders, ensuring clear communication of audit results and next steps. • Handle routine inquiries and relay information between departments and stakeholders. • Assist with maintaining productivity and quality goals. • Monitor and assist with QA chat channels to provide real-time support. • Perform other duties as assigned by management. Qualifications • Bachelor's Degree in health related field required. • Five (5) plus years of clinical experience. • Current and unobstructed RN licensure (Preferred) or equivalent combination of education and/or experience. • Strong attention to detail and organizational skills. • Collaborative and team-oriented approach. • Ability to handle sensitive and confidential information. • Problem-solving mindset and proactive in addressing challenges. • Adaptable and flexible in responding to changing business needs. • Strong knowledge of industry regulations, compliance standards, and audit processes. • Excellent analytical skills with the ability to identify trends and provide actionable insights. • Strong communication skills, both written and verbal. • Experience in coaching and training team members to improve performance and achieve quality goals. • Ability to work independently, prioritize tasks, and manage multiple projects simultaneously. • Familiarity with clinical processes and the handling of clinical escalations is a plus. • Proficiency in quality assurance software, data analysis tools, and Microsoft Office Suite (Excel, Word, PowerPoint). Requirements • Salary: $60,800.00 - 82,100.00 / annually. Benefits • Medical, Dental, and Vision insurance. • Employer Paid Basic Life Insurance and AD&D. • Voluntary Life Insurance (Employee/Spouse/Child). • Health Care and Dependent Care Flexible Spending Accounts. • Pre-Tax and Post-Tax Commuter and Parking Benefits. • 401(k) Retirement Savings Plan with Company Match. • Paid Time Off. • Paid Parental Leave. • Short-Term and Long-Term Disability. • Tuition Reimbursement. • Employee Discounts (retail, hotel, food, restaurants, car rental and much more!). Apply tot his job
Apply Now

Similar Jobs

[Hiring] Clinical Quality Management Auditor @NC Health Affiliates LLC DBA Blue Cross NC

Remote, USA Full-time

Banner Health RN Clinical Auditor & Quality Review Specialist Remote in Wyoming, Wyoming

Remote, USA Full-time

Research Scientist- Immunoassay Development

Remote, USA Full-time

Research Assistant: Biochemist

Remote, USA Full-time

Associate Biochemist: Data Review Dept in Lancaster, PA

Remote, USA Full-time

26 AY Teaching Associate (TA) - Chemistry & Biochemistry

Remote, USA Full-time

Associate Professor -N-T Track Research – Biochemistry & Molecular Biology in Galveston, TX in University of Texas Medical Branch (job Id: 1690669502)

Remote, USA Full-time

Adjunct Faculty – Biochemistry & Biophysics for Discovery

Remote, USA Full-time

Medical Group Compliance Auditor Senior

Remote, USA Full-time

Medical Auditor

Remote, USA Full-time

Remote School Social Worker Virtual Support Opportunity in Las Vegas, NV

Remote, USA Full-time

**Experienced Data Entry Specialist – Remote Opportunity at blithequark**

Remote, USA Full-time

**Experienced Remote Data Entry Specialist – Flexible Work-from-Home Opportunity at blithequark**

Remote, USA Full-time

Market Strategy Specialist, Accounts Receivable Automation and B2B Payments

Remote, USA Full-time

**Experienced Entry-Level Data Entry Specialist – Remote Opportunity at arenaflex**

Remote, USA Full-time

Sr/ Epic Cadence/MyChart Consultant - Contract

Remote, USA Full-time

**Experienced Full Stack Program Manager – Product Innovation and Development at arenaflex**

Remote, USA Full-time

**Experienced Customer Service Representative – Onsite at blithequark**

Remote, USA Full-time

**Experienced Customer Service Associate - Nights and Weekends (Full Time) at blithequark**

Remote, USA Full-time

[Remote] SEM Optimization Specialist - PIQ and Affilate

Remote, USA Full-time
Back to Home