Clinical Quality Analyst - Specialty Pharmacy Audits

Sagility India Private Ltd in; El Paso (TX); On-site; USD 85,000 - 110,000; Full time

Job summary

Sagility India Private Ltd in is seeking a USRN Quality Analyst to ensure adherence to clinical quality standards, regulatory requirements, and client expectations. The role focuses on quality reviews of clinical interactions, patient outreach, and documentation to improve patient experiences and ensure high-quality specialty pharmacy services.

Qualified candidates hold an active US RN license and have 3+ years of clinical nursing experience, plus at least 1 year in quality monitoring or related

Qualifications

• Minimum 3 years of clinical nursing experience.
• Minimum 2 years in Specialty Pharmacy, Utilization Management, Care Management, Disease Management, or related clinical program.
• Minimum 1 year in Quality Assurance, Clinical Auditing, Compliance Review, or Clinical Quality Monitoring.
• Experience reviewing clinical documentation, patient interactions, and quality outcomes.

Responsibilities

• Conduct quality audits of clinical interactions, patient outreach activities, and clinical documentation in accordance with client requirements and regulatory expectations.
• Evaluate the quality and accuracy of patient education, medication adherence discussions, therapy support activities, and clinical documentation.
• Assess compliance with clinical workflows, policies, procedures, and regulatory requirements.
• Identify quality trends, documentation gaps, compliance risks, and opportunities for process improvement.
• Document audit findings and maintain accurate records within designated quality systems.
• Conduct calibration sessions with Operations, Training, Clinical Leadership, and Client stakeholders to ensure consistent interpretation of quality standards.
• Partner with Operations and Training to identify root causes and implement corrective actions based on audit results and quality trends.
• Develop and deliver quality reports, scorecards, and performance insights to leadership and client stakeholders.
• Support quality improvement initiatives focused on member experience, clinical excellence, regulatory compliance, and operational effectiveness.
• Escalate compliance risks, patient safety concerns, and critical quality findings as appropriate.
• Maintain compliance with HIPAA and all applicable federal, state, client, and organizational requirements.

Skills

Clinical judgment

Analytical skills

Communication skills

HIPAA knowledge

Time management

Quality auditing

Education

Nursing degree

US Registered Nurse license

Multi-state Compact RN license

Job description

Sagility India Private Ltd in is seeking a USRN Quality Analyst to ensure adherence to clinical quality standards, regulatory requirements, and client expectations. The role focuses on quality reviews of clinical interactions, patient outreach, and documentation to improve patient experiences and ensure high-quality specialty pharmacy services.

Qualified candidates hold an active US RN license and have 3+ years of clinical nursing experience, plus at least 1 year in quality monitoring or related