Quality Audit Specialist (QAS)

Employment Type: Full-Time

Position Overview

We are looking for a Quality Audit Specialist (QAS) to grow our mission of supporting client quality audits and bringing data-driven continuous readiness to Included Health’s service lines. This role will provide support for pre-audit workflows, real-time audit coordination, and post-audit activities associated with client quality audits. The QAS employs insights, tools, and collaborative partnerships to identify trends and risks across Included Health products. The QAS uses this data to escalate risks and highlight opportunities to Quality Audit leadership, in addition to operational and clinical leaders.

The ideal candidate will have a passion for service and care excellence. They will demonstrate excellent attention to detail and accuracy. You should be analytically oriented, ready to leverage data, and have the ability to effectively problem-solve. The ideal candidate will also bring experience in leading projects, including setting clear objectives, defining the scope of the project, and managing timelines to ensure that projects are completed successfully and efficiently. Project management skills are essential in coordinating cross-functional efforts and ensuring timely audit deliverables. This job will require strong interpersonal skills and an ability to navigate the organization deftly. You should be comfortable taking ownership of your piece of the business and have a desire to collaborate with leadership to make decisions that will have a positive impact on the people we serve.

The Quality Audit Specialist reports to the Senior Manager, Quality Audit.

Responsibilities

Continuous Readiness

• Utilize resources and tools to routinely “test the system” for audit readiness, proactively and in real-time identifying gaps.
• Analyze, synthesize, and communicate insights to Member Care and Clinical leadership.
• Provide education and training on audit processes and procedures to cross-functional teams, ensuring readiness to meet audit criteria.
• Provide education and guidance regarding gaps surfaced in audits and call listening sessions, in partnership with Member Care Operations, Member Care, and Clinical leadership.

Audit Coordination and Support

• Deploy the audit playbook for each audit.
• Facilitate distribution of materials supporting audit activity, both internally- and client-facing.
• Support and/or lead internal meetings associated with an audit.
• Document learnings and findings throughout the audit lifecycle.

Post-Audit Activities

• Support remediation plans through identification of and collaboration with designated remediation owners, plus tracking to tasks and timelines.
• Document audit findings to include recommendations for operational, clinical, product, go to market, and other teams as appropriate.
• Track and trend remediation efforts coupled with findings across all client audits.
• Support involved leadership teams in post-audit activities.

Requirements

• 3+ years of experience in quality assurance or data analysis, with a proven ability to interpret complex data and identify improvement opportunities.
• Experience utilizing quality improvement frameworks and leading quality improvement efforts.
• Strong interpersonal skills and the ability to build positive relationships with employees at all levels of the organization.
• Passionate about excellence in customer service.
• Hands-on involvement in roles requiring direct customer interaction.
• Analytical mindset with the ability to interpret data and derive actionable insights.
• Must work well under pressure with a proactive approach, including managing multiple deadlines and priorities.
• Self-starter with the ability to quickly pick up new content and processes in a fast-paced, dynamic work environment.
• Ability to create reports, dashboards, and visualizations.
• Proficient with Google Workspace tools and Mac OS.
• College degree or equivalent experience.

Company Information

Salary: The United States new hire base salary target ranges for this full-time position are: Zone A: $85,320 - $110,910 + equity

Location Type: (Information not provided)