Healthcare Quality Mgmt Consultant Job at SGS Consulting, Remote

L1YwdGdsdmtHMGRsTXNjREY1M3RzUzQySHc9PQ==
  • SGS Consulting
  • Remote

Job Description

Job Responsibilities:

  • Collaborate with underwriting, sales, data science, and audit teams to conduct quality audit reviews on a variety of business documentation, processes, and systems. Audit types include but are not limited to the following, SOX audit, peer review audit, sales review audit, signed contract review audit.
  • Drive automation and reporting tools to streamline quality reviews and enhance data transparency.
  • Promptly resolve issues related to audit findings and provide status updates to leadership throughout audit process, e.g., from audit completion through audit finding resolution.
  • Work closely with Business Analytics to identify patterns of procedural errors and improvement areas and to develop actionable solutions.
  • Present quality insights, metrics, and recommendations to senior leadership in a clear, data-supported format.
  • Maintain data-driven KPIs and quality scorecards to monitor underwriting performance, consistency, and compliance.
  • This role requires someone with superior organizational skills, logic and problem-solving skills, including high level of attention to detail and the ability to deliver on multiple and competing priorities.

Skills:

  • 1+ year of audit or underwriting experience, including at least 1 year in a quality assurance capacity.
  • 1+ year of experience using Salesforce.
  • Background in PBM industry.

Education/Experience:

  • Bachelor’s degree in Business, Finance, Risk Management, Legal, or comparable work experience in a related field.

Job Tags

Remote job, Contract work, Work experience placement

Similar Jobs

Victoria Logistics Carrier LLC

Sprinter/Cargo Van Owner Operator Job at Victoria Logistics Carrier LLC

 ...Hello, guys! We are hiring Cargo Van and Sprinter Van owner-operators for our company, VICTORIA LOGISTICS CARRIER. We work within...  ...: You should have your own vehicle (Sprinter / Box Truck / Straight truck). Be: a US citizen, resident, green card or... 

Confidential

New York - Public Relations / Event Internship Job at Confidential

 ...american PR company. This PR / Event internship will take place in New York. Their clients are usually international brand in the fashion industry. The students will learn a lot about the fashion industry and aquire new skills for his/her future career as PR or event... 

Farm Job Search

Farm Manager Job at Farm Job Search

 ...Farm Manager (6505) Location: Long Valley, New Jersey JobNumber: 6505 Farm Mgr. of Regenerative Organic Farm that provides produce to our own Meal Kitting business. It has a large, state of the art Green-house Aquaponics operation, 20 acres of no-till organic... 

Red Bull

Merchandiser (Part Time) Job at Red Bull

 ...Reporting to the Merchandiser Manager, the primary role of the Part-time Merchandiser (PTM) is to service our customers in a safe manner by ensuring level of stock is maintained and rotated correctly at large format "off premise" stores. You will support our sales by... 

AO Ascension

Insurance Representative Job at AO Ascension

 ...for over 68 years. We are a company that works with over 40,000 different labor unions,...  ...summary: American Income Life is a leading insurance and supplemental benefits provider. The...  ...full training ~ Remote work from home option ~100% Commission Pay ONLY ~ Residual...