Clinical Validation Audit Quality Manager

ExlService Holdings, Inc.; United States; Remoto; USD 75.000 - 123.000; Tempo integral

Resumo da vaga

ExlService Holdings, Inc. in the United States seeks a CVA Quality Manager to lead planning, coordination, and execution of Clinical Validation Audit quality review activities, ensuring productivity, inventory, client SLAs, and internal standards are met.

You will directly manage a team of CVA quality analysts responsible for reviewing auditor-completed Clinical Validation Audit work and validating outcomes. Strong clinical knowledge and CMS/payer requirements are essential.

Qualificações

• Experience leading clinical validation audits and teams.
• Strong analytical and problem-solving abilities.
• In-depth clinical knowledge and record-review expertise.

Responsabilidades

• Lead planning, coordination, and execution of validation audit quality reviews.
• Manage CVA quality analysts and ensure audit accuracy and outcomes.
• Collaborate cross-functionally to support program success and meet SLAs.
• Oversight of inventory, QA aging, and risk management.

Conhecimentos

Leadership

Analytical skills

Clinical knowledge

CMS regulations

Payer requirements

Ferramentas

Audit tools

Descrição da vaga

The CVA Quality Manager leads the planning, coordination, and execution of Clinical Validation Audit quality review activities, ensuring quality teams meet productivity goals, inventory expectations, client SLAs, and internal quality standards. This role oversees inventory, QA aging, risks, and day-to-day quality performance, while collaborating cross-functionally to support program success.

The role directly manages a team of CVA quality analysts responsible for reviewing auditor-completed Clinical Validation Audit work, validating audit accuracy, and ensuring accurate clinical validation outcomes. This leader may also oversee additional quality specialties within clinical or coding audit programs. The ideal candidate demonstrates strong leadership and analytical skills, along with expert clinical knowledge, experience with inpatient medical record review, clinical criteria documentation requirements, audit tools, and a solid understanding of CMS regulations, payer requirements, and quality governance.

Salary Range: $75,100 – $123,400, based on experience, skills, and qualifications.

Location: 100% Remote, U.S.-based.

Travel: Limited travel may be required for team meetings.

A brief coding/auditing assessment may be included as part of the interview process.

For more information on benefits and what we offer, please visit us at https://www.exlservice.com/us-careers-and-benefits