Senior Remote Clinical Validation Audit Lead

EXL Talent Acquisition Team; United States; Remote; USD 75,000 - 123,000; Full time

Job summary

EXL is seeking a CVA Quality Manager to lead planning, coordination, and execution of Clinical Validation Audit quality review activities, ensuring teams meet productivity and quality standards. You will manage a team of CVA quality analysts, review auditor-completed work, validate outcomes, and collaborate across functions to support program success.

This role requires strong leadership, clinical knowledge, and familiarity with CMS regulations.

Qualifications

• Strong leadership and analytical skills with expert clinical knowledge.
• Experience with inpatient medical record review and clinical criteria documentation requirements.
• Solid understanding of CMS regulations, payer requirements, and quality governance.

Responsibilities

• Lead the planning, coordination, and execution of CVA quality review activities.
• Oversee inventory, QA aging, risks, and day-to-day quality performance.
• Directly manage CVA quality analysts reviewing auditor-completed work and validating outcomes.

Job description

EXL is seeking a CVA Quality Manager to lead planning, coordination, and execution of Clinical Validation Audit quality review activities, ensuring teams meet productivity and quality standards. You will manage a team of CVA quality analysts, review auditor-completed work, validate outcomes, and collaborate across functions to support program success.

This role requires strong leadership, clinical knowledge, and familiarity with CMS regulations.