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 risk across Included Health products. The QAS uses these 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 project scope of the project, allocating resources and managing timelines to ensure that projects are completed successfully and efficiently.
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 & Knowledge Enablement.
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 plan 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
Required Qualifications:
- 3+ years of quality or data analysis and interpretation experience
- College degree or equivalent experience
- Experience managing projects
- 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
- 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 ability to quickly pick up new content and processes in a fast-paced, dynamic work environment
- Ability to create reports, dashboards and visualizations
- Experience with Google Workplace platform and Mac OS
Preferred Qualifications:
- Previous health care experience
The duties and responsibilities in this job description are neither exclusive nor exhaustive and will be updated on a regular basis and may be amended in the light of changing circumstances or business needs. While this job description is intended to be an accurate reflection of the current job, Included Health reserves the right to add, modify, or exclude any duty or requirement at any time or without any notice. FInally, this job description is not intended in any way to create a contract of employment.The United States new hire base salary target ranges for this full-time position are:Zone A: $63,670 - $82,770 + equity + benefitsZone B: $73,221 - $95,180 + equity + benefitsZone C: $79,588 - $103,460 + equity + benefitsZone D: $82,771 - $107,590 + equity + benefitsThis range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone.
Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.Starting base salary for the successful candidate will depend on several job-related factors, unique to each candidate, which may include, but not limited to, education; training; skill set; years and depth of experience; certifications and licensure; business needs; internal peer equity; organizational considerations; and alignment with geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and competitive compensation based on their roles and locations. Your Recruiter can share details of your geographic alignment upon inquiry.In addition to receiving a competitive base salary, the compensation package may include, depending on the role, the following:Remote-first culture401(k) savings plan through FidelityComprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependentsGenerous Paid Time Off ("PTO") and Discretionary Time Off ("DTO")12 weeks of 100% Paid Parental leaveFamily Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistanceCompassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)11 Holidays Paid with one Floating Paid HolidayWork-From-Home reimbursement to support team collaboration and effective home office work24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations
About Included Health
Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care.
It’s all included. Learn more atincludedhealth.com. -----Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.Apply for this job
