Senior Clinical Quality Assurance Analyst
Core
Ensuring clinical oversight, quality improvement, and compliance with healthcare standards while supporting clinical product strategy and implementation.
Role type
Senior Clinical Quality Assurance Analyst
Builds
Quality management services, clinical auditing programs, and data-driven solutions for healthcare clients.
Domain
Healthcare / Clinical Quality & Risk Adjustment
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
ICD-10 diagnosis coding, HEDIS quality measures, risk adjustment coding, clinical nursing background, AI tools understanding, process development, clinical auditing, stakeholder management
Preferred skills
Healthcare plan quality improvement initiatives, public programs experience (Medicare/Medicaid)
Technologies
AI tools, reporting mechanisms, management tools
Responsibilities
Develop and implement companywide quality improvement efforts; monitor quality and reliability of reporting mechanisms; perform analysis of reviews and lead consolidation of findings; ensure compliance with quality standards; support clinical product strategy through research and development; support clinical product implementations; develop and execute training processes; maintain communication regarding quality activity; develop recommendations for process changes; manage internal and client-facing clinical auditing programs; support client relationships and resolve service issues.
Seniority
Senior, hands-on IC