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Allied Benefit Systems · 6 days ago

Training and Quality Auditor

United States

Full-time

Remote

Entry, Mid Level

$50K/yr - $60K/yr

2+ years exp

Allied Benefit Systems is a company focused on providing quality training and compliance in the healthcare sector. The Training and Quality Auditor will develop training programs, manage audits, and collaborate with various departments to enhance training and quality processes.

Health CareInsuranceWellness

Responsibilities

Develop course content, core competencies, evaluation tools, and materials for training activities

Manage quarterly updates of reference materials for proprietary strategies and other assigned areas

Proposes and implements recommendations for improved processes including the identification of training requirements, training gap analysis, and employee needs assessment/s

Designs, delivers and responds to development requests from other departments

Organize and facilitate the onboarding of department new hires

Facilitates, and reviews audit results from all department teams; audits consist of any entry made related to a member

Identify and analyze case impacts for Allied Care Medical Management Reporting to ensure content represents overall member engagement to further enhance client retention and assist in marketing to new business

Perform audits of department-related claims, specifically CVS Caremark, limited distribution drug arrangements, transplant, and miscellaneous claims processed by the Enhanced Case Management Advocate to ensure appropriate payment is made

Identifies department-wide trends and offers suggestions for improvement and or additional areas of focus

Collaborate with Data Analyst in data gathering, analysis, and reporting metrics as needed

Collaborate with Data Analyst to identify enhancements that will improve processes and support future business needs

Other duties as assigned