Modivcare · 1 month ago
Clinical Quality Assurance Auditor
United States
Full-time
Remote
Senior Level
$61K/yr - $82K/yr
5+ years expModivcare is a company dedicated to improving healthcare services, and they are looking for a Clinical Quality Assurance Auditor. This role involves auditing calls and clinical processes to ensure compliance with healthcare regulations, processing clinical escalations, and enhancing the overall customer experience through quality monitoring and team development.
Health CareMedicalPersonal HealthTransportation
Responsibilities
Implements audit strategies to assess the quality of calls, compliance with healthcare regulations, and overall adherence to quality standards
Conduct audits on calls, clinical charts, processes, procedures, and systems to ensure adherence to industry standards
Process and respond to unresolved escalations (issues that arise in calls that are unable to be resolved in the moment), working closely with relevant teams to address issues and provide timely resolutions
Complete reviews of clinical escalations resulting from outlier biometrics for process and quality recommendations
Communicates audit findings, analysis, and recommendations to senior management and key stakeholders
Highlight trends, actionable insights, and areas requiring improvement
Collaborates with internal teams to identify action plans and implement corrective actions based on audit findings
Tracks and monitors the progress of these action plans
Provides coaching and development to team members on job skills, delivery skills, and quality improvement
Offers targeted support for individuals needing additional coaching on soft skills or specific job tasks to enhance team performance
Ensures ongoing compliance with quality standards, industry regulations, and internal policies by extracting and evaluating calls
Monitors and assists in meeting compliance and productivity goals
Analyze call data to identify trends, gaps, and areas for improvement
Prepare reports to share with senior management for decision-making purposes
Build and maintain strong relationships with internal and external stakeholders, including healthcare providers, patients, and regulatory agencies
Ensure clear communication of audit results and next steps to involved parties
Handles routine inquiries and relay information between departments and stakeholders
Maintains security and access to sensitive materials
Assists with maintaining productivity and quality goals
Monitors and assists with QA chat channels to provide real-time support
Performs other duties as assigned by management
Qualification
Required
Bachelor's Degree in health related field required
Five (5) plus years of clinical experience
Strong attention to detail and organizational skills
Collaborative and team-oriented approach
Ability to handle sensitive and confidential information
Problem-solving mindset and proactive in addressing challenges
Adaptable and flexible in responding to changing business needs
Strong knowledge of industry regulations, compliance standards, and audit processes
Excellent analytical skills with the ability to identify trends and provide actionable insights
Strong communication skills, both written and verbal, with the ability to report findings and collaborate with various departments
Experience in coaching and training team members to improve performance and achieve quality goals
Ability to work independently, prioritize tasks, and manage multiple projects simultaneously
Preferred
Current and unobstructed RN licensure
Or equivalent combination of education and/or experience
Familiarity with clinical processes and the handling of clinical escalations is a plus
Proficiency in quality assurance software, data analysis tools, and Microsoft Office Suite (Excel, Word, PowerPoint)
Benefits
Medical, Dental, and Vision insurance
Employer Paid Basic Life Insurance and AD&D
Voluntary Life Insurance (Employee/Spouse/Child)
Health Care and Dependent Care Flexible Spending Accounts
Pre-Tax and Post --Tax Commuter and Parking Benefits
401(k) Retirement Savings Plan with Company Match
Paid Time Off
Paid Parental Leave
Short-Term and Long-Term Disability
Tuition Reimbursement
Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)
Company
Modivcare
ModivCare is a healthcare services company that provides emergency medical transportation and care-centric solutions.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$730MKey Investors
Coliseum Capital ManagementJP Morgan Chase
2025-08-20Post Ipo Debt· $100M
2025-01-10Post Ipo Debt· $105M
2024-07-03Post Ipo Debt· $525M
Leadership Team
B
Barbara Gutierrez
Chief Financial Officer
Jeff Bennett
Chief Strategy and Innovation Officer
Recent News
Home Health Care News
2025-12-14
Morningstar.com
2025-12-13
Home Health Care News
2025-10-21
Company data provided by crunchbase