Healthcare Quality Mgmt Consultant Job at SGS Consulting, Remote

MnMrY0NnaWdjcGhsTHNsaVB1VVljSHhsVFE9PQ==
  • SGS Consulting
  • Remote

Job Description

Job Responsibilities:

  • Collaborate with underwriting, sales, data science, and audit teams to conduct quality audit reviews on a variety of business documentation, processes, and systems. Audit types include but are not limited to the following, SOX audit, peer review audit, sales review audit, signed contract review audit.
  • Drive automation and reporting tools to streamline quality reviews and enhance data transparency.
  • Promptly resolve issues related to audit findings and provide status updates to leadership throughout audit process, e.g., from audit completion through audit finding resolution.
  • Work closely with Business Analytics to identify patterns of procedural errors and improvement areas and to develop actionable solutions.
  • Present quality insights, metrics, and recommendations to senior leadership in a clear, data-supported format.
  • Maintain data-driven KPIs and quality scorecards to monitor underwriting performance, consistency, and compliance.
  • This role requires someone with superior organizational skills, logic and problem-solving skills, including high level of attention to detail and the ability to deliver on multiple and competing priorities.

Skills:

  • 1+ year of audit or underwriting experience, including at least 1 year in a quality assurance capacity.
  • 1+ year of experience using Salesforce.
  • Background in PBM industry.

Education/Experience:

  • Bachelor’s degree in Business, Finance, Risk Management, Legal, or comparable work experience in a related field.

Job Tags

Remote job, Contract work, Work experience placement,

Similar Jobs

Dane Street, LLC

Orthopedic Surgeon - Honolulu, HI Job at Dane Street, LLC

 ...Dane Street is seeking a Board-Certified Orthopedic Surgeon to join our team in Honolulu, HI , to perform Independent Medical Examinations...  .... Qualifications: Board Certification in Orthopedic Surgery (required) Active Medical License in Hawaii (required)... 

Fuku

Senior Product Designer Job at Fuku

 ...Senior Product Designer About the Company - Client is an AI-native platform transforming compliance from manual, tedious work into...  ...startup/growth-stage experience 2. Candidates too junior or entry-level 3. Weak design opinions/lack of data-driven approach 4.... 

Graphic Packaging International, Inc.

Warehouse Coordinator II Job at Graphic Packaging International, Inc.

 ...TBD Waco Required Experience At Graphic Packaging International, we produce the paper cup that held your coffee this morning, the basket that transported those bottles of craft beer you enjoyed last weekend, and the microwave tray that heated your gourmet... 

Night Watch Urgent Care

Medical Receptionist Job at Night Watch Urgent Care

 ...About the Job: As the Front Desk Receptionist in our pediatric and adult urgent care facility, you will serve as the first point of contact for patients, families, and visitors. Your primary responsibility will be to ensure a smooth and efficient patient experience by... 

Top Level Promotions

Office Administration Assistant - Work from Home Job at Top Level Promotions

 ...Work from Home Data Entry & Office Administration Remote Online Role About the Job...  ...No experience is required, and full training is provided. This role is ideal for anyone...  ...Flexible part-time or full-time hours Paid training included Opportunity to gain...