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

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 To this Job