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Quality Assurance Specialist

2 months ago

Rapid City, South Dakota, United States Collabera Full time

Position: Quality Auditor
Work Arrangement: Remote
Contract Length: 5 months
Employer: Collabera

Key Responsibilities:

  • Perform comprehensive evaluations at healthcare provider locations to examine the clinical environment, the quality of medical documentation, and adherence to established documentation protocols.
  • Compile detailed reports to convey findings to healthcare providers, offering educational insights and identifying areas for enhancement.
  • Deliver analytical support to aid in the assessment process and identify trends for quality enhancement and health management initiatives.
  • Support the Quality Management division with various specialized projects and targeted clinical assessments.
  • Execute additional tasks or focused studies as needed.
  • Facilitate training sessions for internal personnel, healthcare providers, and vendors regarding auditing standards and programs, both remotely and in-person.
  • Act as a primary contact and project coordinator for state-level audits, interpreting audit results.
  • Generate various analytical reports as required.
  • Oversee and manage the Corrective Action Plan (CAP) process for designated audit categories.
  • Conduct follow-up audits to verify that previously identified issues have been resolved.

Essential Qualifications:

  • Registered Nurse credential.
  • Understanding of managed care principles.
  • Familiarity with medical terminology.
  • Proficient in using computers and relevant software applications.
  • Preferred knowledge of URAC accreditation standards and HEDIS metrics.
  • Preferred experience in health management or patient education.