Quality Coach

Actalent; Des Moines (IA); Remote; USD 10,000 - 60,000; Full time

Job summary

An innovative firm is seeking a Quality Coach to support adherence to processes in Utilization and Case Management. This fully remote role involves validating denial letters and conducting call quality assurance to ensure compliance with HIPAA. The ideal candidate will possess strong communication and analytical skills, along with a background in nursing. Join a leading organization where your expertise will contribute to enhancing quality in health services, all while enjoying a flexible work environment and comprehensive benefits.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave (PTO, Vacation or Sick Leave)

Qualifications

• Completion of an accredited registered nursing program.
• Active RN license in Iowa or South Dakota required.
• 4+ years of clinical or equivalent industry experience.

Responsibilities

• Perform denial letter validation for quality assurance.
• Conduct call quality assurance using AWS systems.
• Evaluate, coach, and mentor in operational processes.

Skills

Strong communication skills

Analytical skills

Technical aptitude

Ability to establish positive relations

Education

Registered Nursing Program

Active RN License in Iowa or South Dakota

Tools

Microsoft Office Suite

Electronic charting/documentation systems

AWS systems

Job description

3 days ago Be among the first 25 applicants

Job Description

Support the company's adherence to processes within Utilization Management and Case Management. This role includes reviewing and performing denial letter validation, ensuring quality in all aspects of denial letters. The position may also involve call quality assurance, using AWS systems to listen to calls for compliance, ensuring adherence to HIPAA requirements.

Job Title: Quality Coach

Job Description

Support the company's adherence to processes within Utilization Management and Case Management. This role includes reviewing and performing denial letter validation, ensuring quality in all aspects of denial letters. The position may also involve call quality assurance, using AWS systems to listen to calls for compliance, ensuring adherence to HIPAA requirements.

Responsibilities

• Perform denial letter validation to ensure quality and adherence to processes.
• Conduct call quality assurance using AWS systems to ensure compliance with HIPAA requirements.
• Support Utilization Management and Case Management processes.
• Evaluate, coach, and mentor others in complex operational processes or health services-related quality reviews.
  
  

Additional Skills & Qualifications

• Completion of an accredited registered nursing program.
• Active and Unrestricted Registered Nurse (RN) license in Iowa or South Dakota.
• 4+ years of clinical or equivalent industry experience.
• Strong communication skills for articulating complex information.
• Ability to establish and maintain positive relations with colleagues, stakeholders, and customers.
• Analytical skills for evaluating data/trends and solving practical problems.
• Experience with Microsoft Office Suite and electronic charting/documentation systems.
• Technical aptitude to learn new systems.
• Interrater Reliability Certification (IRR) preferred.
  
  

Work Environment

This is a 100% fully remote position, requiring 40 hours per week with availability from 8 am to 5 p.m. The contract is anticipated to cover parental leave, with a target start date no later than the end of May and expected to continue through August 2025.

Pay and Benefits

The pay range for this position is $35.00 - $40.00/hr.

Eligibility requirements apply to some benefits and may depend on your job

classification and length of employment. Benefits are subject to change and may be

subject to specific elections, plan, or program terms. If eligible, the benefits

Available For This Temporary Role May Include The Following

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
  
  

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on May 20, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [e-mail] for other accommodation options.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Management and Manufacturing

• Industries

  Business Consulting and Services

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