Healthcare Quality Management Consultant - Remote

Title: Healthcare Quality Management Consultant - Remote

Mandatory skills:

audit, underwriting,
quality assurance,
Salesforce, PBM,
spreadsheets, sales, data science,
PBM Underwriting Quality Management,
SOX audit, peer review audit, sales review audit, quality audit review, contract review audit,
business analytics, business documentation, business process, business systems,
automation, reporting tools, quality review, data transparency, audit process, audit completion,
data-driven KPI, quality scorecards, mitigate risk, quality control,
monitor, compliance, records, reports, accountable, communication, organization, collaboration, develop, problem solving

Description:

Position Summary:
As a Quality Auditor you will be part of our PBM Underwriting Quality Management Team. This position will provide strategic support to the department and execute on new processes to mitigate risk. The primary focus of the role is to perform various audits and report on status, results, and trends. As an individual contributor, you will have the opportunity to showcase your strong attention to detail, your sense of urgency, and show how highly organized you are with competing priorities. You will also identify improvement areas for quality control, present recommendations, and bring improvements to fruition. This position will work closely with cross-functional business partners at all levels of the organization.

Duties:
Key Responsibilities:
Collaborate with underwriting, sales, data science, and audit teams to conduct quality audit reviews on a variety of business documentation, processes, and systems. Audit types include but are not limited to the following, SOX audit, peer review audit, sales review audit, signed contract review audit.
Drive automation and reporting tools to streamline quality reviews and enhance data transparency.
Promptly resolve issues related to audit findings and provide status updates to leadership throughout audit process, e.g., from audit completion through audit finding resolution.
Work closely with Business Analytics to identify patterns of procedural errors and improvement areas and to develop actionable solutions.
Present quality insights, metrics, and recommendations to senior leadership in a clear, data-supported format.
Maintain data-driven KPIs and quality scorecards to monitor underwriting performance, consistency, and compliance.
This role requires someone with superior organizational skills, logic and problem-solving skills, including high level of attention to detail and the ability to deliver on multiple and competing priorities.

Experience :
Qualifications:
Strong attention to detail, evidenced by accurately entering data into spreadsheets, carefully following instructions to complete tasks, and creating records and reports for later reference.
Strong time management skills, evidenced by experience being accountable to multiple deliverables on staggered deadlines.
Effective communication skills in both formal and informal written communications and speech at all levels of an organization.
1+ year of audit or underwriting experience, including at least 1 year in a quality assurance capacity.
1+ year of experience using Salesforce.
Background in PBM industry.

Education:
Bachelor s degree in Business, Finance, Risk Management, Legal, or comparable work experience in a related field.

VIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at for any complaints, comments and suggestions.

Contact Details :

VIVA USA INC.
3601 Algonquin Road, Suite 425
Rolling Meadows, IL 60008