Healthcare Quality Mgmt Consultant Job at SGS Consulting, Remote

TStIRHpJRS9OcmpOVUlIZnVjNjN0M2doa3c9PQ==
  • 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

ATPCO

SOC Analyst Intern Job at ATPCO

 ...your wellbeing comes first Our Culture: Weve built a remote-first culture rooted in trust, transparency, and belonging. With...  ...Job Description Overview The ATPCO Security Operations (SOC) Internship is a 12-week program designed to give college... 

Gardens of Babylon, LLC

Landscape Designer Job at Gardens of Babylon, LLC

 ...Landscape Designer Gardens of Babylon - Nashville, TN $35,000 - $50,000 a year Gardens of Babylon, Nashville's largest family...  ...Must have a valid drivers license Have a B.S. Degree in architectural design or similar field Must have at least 3-5 years of... 

Ganahl Lumber Co

Truck Driver - Class C Job at Ganahl Lumber Co

 ...TRUCK DRIVER CLASS - C Job Summary: This position requires the ability to drive a truck with a capacity of at least 26,001 pounds Gross Vehicle Weight Rating (GVWR). May load and unload vehicle as required. Requires commercial drivers license. Supervisory Responsibilities... 

Uniti Med

Travel PICU Registered Nurse - $2,609 per week Job at Uniti Med

 ...Uniti Med is seeking a travel nurse RN PICU - Pediatric Intensive Care for a travel nursing job in Newark, New Jersey. Job Description & Requirements ~ Specialty: PICU - Pediatric Intensive Care ~ Discipline: RN ~ Start Date: 01/26/2026~ Duration: 13 weeks... 

Tek Ninjas

Surgical Tech Job at Tek Ninjas

 ...personnel. There is an on-call component to this position. Compliance with all applicable State and Federal laws, regulations, and policies governing the provision of health care. Option - 4x10's ( 7:00am-5:30pm or 8:00am-6:30pm) or 5 8's (7:00am-3:30pm, 9:00am-...