Provider Quality Auditor

Ursus; Sacramento (CA); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player in healthcare quality management is seeking a dedicated professional to enhance patient care and satisfaction. This role offers the chance to work remotely while making a significant impact on quality assurance initiatives. With opportunities for career advancement, you will be part of a supportive team focused on delivering exceptional service. If you have a passion for quality management and a commitment to excellence, this position is perfect for you.

Benefits

Comprehensive Medical Benefits

Dental Insurance

Vision Insurance

401K with Company Matching

Career Advancement Opportunities

Remote Work Flexibility

Qualifications

• 2+ years in managed care or quality management.
• Strong communication and analytical skills required.

Responsibilities

• Monitor and evaluate quality of care and service for members.
• Coordinate Quality Assurance reviews and investigate complaints.

Skills

Analytical Skills

Communication Skills

Customer Service

Quality Management

Education

Bachelor's Degree in Business

Equivalent Experience

Job description

Employer Industry: Healthcare Quality Management

Why consider this job opportunity:

• Salary up to $29.38/hr
• Opportunity for career advancement and growth within the organization
• Remote work flexibility
• Comprehensive benefits including Medical, Dental, Vision, and 401K with company matching
• Supportive and collaborative work environment
• Chance to make a significant impact on quality of care and patient satisfaction

What to Expect (Job Responsibilities):

1. Initiate monitoring and evaluation activities to maintain quality of care and service for members
2. Coordinate Quality Assurance reviews and Potential Quality of Care investigations
3. Obtain and review patient medical records from participating doctors
4. Investigate and resolve Potential Quality of Care complaints
5. Prepare summary reports for medical directors and monitor patient complaint trends

What is Required (Qualifications):

1. Bachelor's Degree in Business or related field, or equivalent experience
2. Minimum of 2 years’ experience in managed care or quality management
3. Minimum of 2 years of customer service experience in a service-oriented environment
4. Excellent written, verbal, and interpersonal communication skills
5. Proven analytical and critical thinking skills

How to Stand Out (Preferred Qualifications):

1. Experience working directly with healthcare providers
2. Strong attention to detail and ability to handle moderately complex assignments
3. Self-motivated with the ability to work independently and in a team environment

Additional Information:

#HealthcareQuality #QualityManagement #RemoteWork #CareerOpportunity #PatientCare

We prioritize candidate privacy and champion equal-opportunity employment. Our role is to connect outstanding candidates with a top-tier employer. We are not the Employer of Record for this position.

About the company

Ursus is a minority-owned business dedicated to delivering a better staffing experience to Global 1000 and startup companies. We focus on understanding our clients' needs and responding with relentless attention to detail.