Quality Audit Specialist

Summary

Join Included Health as a Quality Audit Specialist (QAS) to support client quality audits and foster continuous readiness across service lines. You will support pre-audit workflows, real-time audit coordination, and post-audit activities. Leveraging insights and tools, you will identify trends and risks, escalating concerns and highlighting opportunities to leadership. The ideal candidate is passionate about service excellence, detail-oriented, analytically inclined, and possesses strong project management skills. This role demands strong interpersonal skills, ownership, and a collaborative spirit. The QAS reports to the Senior Manager, Quality Audit. This position offers a competitive salary and a comprehensive benefits package.

Requirements

• 3+ years of experience in quality assurance or data analysis, with a proven ability to interpret complex data and identify improvement opportunities
• Experience utilizing quality improvement frameworks and leading quality improvement efforts
• Strong interpersonal skills and the ability to build positive relationships with employees at all levels of the organization
• Passionate about excellence in customer service
• Hands-on involvement in roles requiring direct customer interaction
• Analytical mindset with the ability to interpret data and derive actionable insights
• Must work well under pressure with a proactive approach including managing multiple deadlines and priorities
• Self-starter with ability to quickly pick up new content and processes in a fast-paced, dynamic work environment
• Ability to create reports, dashboards and visualizations
• Proficient with Google Workspace tools and Mac OS
• College degree or equivalent experience

Responsibilities

• Utilize resources and tools to routinely “test the system” for audit readiness, proactively and in real-time identifying gaps
• Analyze, synthesize, and communicate insights to Member Care and Clinical leadership
• Provide education and training on audit processes and procedures to cross-functional teams, ensuring readiness to meet audit criteria
• Provide education and guidance regarding gaps surfaced in audits and call listening sessions, in partnership with Member Care Operations, Member Care and Clinical leadership
• Deploy the audit playbook for each audit
• Facilitate distribution of materials supporting audit activity, both internally- and client-facing
• Support and/or lead internal meetings associated with an audit
• Document learnings and findings throughout the audit lifecycle
• Support remediation plan through identification of and collaboration with designated remediation owners plus tracking to tasks and timelines
• Document audit findings to include recommendations for operational, clinical, product, go to market and other teams as appropriate
• Track and trend remediation efforts coupled with findings across all client audits
• Support involved leadership teams in post-audit activities

Benefits

• Remote-first culture
• 401(k) savings plan through Fidelity
• Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
• Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents
• Generous Paid Time Off ("PTO") and Discretionary Time Off ("DTO")
• 12 weeks of 100% Paid Parental leave
• Family Building Benefit with fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance
• Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)
• 11 Holidays Paid with one Floating Paid Holiday
• Work-From-Home reimbursement to support team collaboration and effective home office work
• 24 hours of Paid Volunteer Time Off ("VTO") Per Year to Volunteer with Charitable Organizations