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AmeriHealth Caritas · 5 hours ago

Quality Auditing Team Lead

Philadelphia, PA

Full-time

Hybrid

Mid, Senior Level

4+ years exp

AmeriHealth Caritas is a mission-driven organization with over 30 years of experience in delivering comprehensive healthcare solutions. The Quality Auditing Team Lead will oversee daily operations, manage multiple audits, and support continuous improvement initiatives to ensure adherence to quality standards.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Lead and manage audits: Performance Management, Compliance, Enterprise Operations, Pre-Production, and Target audits

Apply comprehensive knowledge of business rules, policies, and procedures across multiple lines of business; communicate findings clearly

Oversee Quality Auditing appeals process: documentation, tracking, decision-making, and resolution guidance

Develop and implement protocols, policies, procedures, and operational strategies for Quality Auditing programs

Identify system or operational issues impacting quality performance; provide analysis and recommendations

Coordinate audit inventory, tasks, and projects to ensure timely completion

Coach and provide feedback to team members to improve accuracy and performance

Represent Quality Auditing in meetings and cross-functional initiatives

Respond professionally to inquiries related to audits, appeals, and special projects

Maintain audit documentation and records per retention policies

Report content or system issues related to audit tools and platforms (e.g., Online Help, Facets, IAD)

Qualification

Quality AuditingHealthcare Industry ExperienceMicrosoft Office SuiteAnalytical SkillsCommunication SkillsLeadership SkillsCollaboration Skills

Required

Bachelor's Degree or equivalent experience

Minimum 1 year of internal quality auditing experience

Minimum 3 years of healthcare industry experience

Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)

Strong analytical and problem-solving skills

Excellent communication, leadership, and collaboration skills

Preferred

Access preferred

Benefits

Flexible work solutions include remote options

Hybrid work schedules

Competitive pay

Paid time off

Holidays and volunteer events

Health insurance coverage for you and your dependents starting Day 1

401(k) retirement savings plan

Tuition reimbursement

And more.

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)