Job Description
The Senior Manager of Quality Audit is responsible for leading Included Health’s centralized audit function to support client audits of our care and services. This function drives the strategy and execution of the Quality Audit Program. They provide oversight and ownership of continuous readiness, real-time audit coordination/support and post-audit activities associated with scheduled and ad-hoc client audits. The Senior Manager of Quality Audit will report to the Director of Operations Performance and is a people manager.
Responsibilities:
Continuous Audit Readiness:Maintain a deep knowledge of customer contracts, performance guarantees and current riskRegularly “test the system” for audit readiness to proactively identify gapsEnsure organization is knowledgeable on audit evaluation criteria and partner with training, product, operational teams and clinical teams to ensure readiness to meet audit criteriaCoordination with training, clinical operations and quality and operational leadership to train on knowledge gaps identified through tracersDrive toward automation for Included Health’s “standard” auditsEnsure our audit methodology is compliant
Audit Coordination and Support:Drive creation of materials utilized in audits- both internal and customer-facingCreate audit plan, which will include roles and responsibilities, timeline, tasks, risks, issues and goalsSchedule and run internal meetings associated with an auditPull relevant audit data as defined by audit requirements (e.g. calls, chats, cases, etc.)If onsite, coordinate catering and customer transportationSend leadership/executive status updates leading up to and during auditOrchestrate meetings with external auditors- prepare agendas, coach speakers, etc.
Post-audit Activities:Manage remediation plan, pulling in appropriate stakeholders, prioritizing findings and holding team accountable to tasks and timelinesDocument audit findings in an executive summary which will include recommendations for operational, clinical, product and technology teamsSupport Client Success Executive in post-audit activities
Leadership:Regular communication with Senior Leadership on audit status and project plansOversee Quality Audit Specialist (s) to execute on day to day program activitiesResponsible for the career development of Quality Audit Specialist teamRequired Qualifications:
Bachelors Degree3+ years working for a benefit consultancy firm OR, 3+ years working in healthcare or healthcare adjacent internal audit readiness5+ years project management experience - specifically managing cross functional projects5+ years leadership experiencing managing project managers and/or audit consultants2+ experience working with healthcare data and/or quality metricsAbility to lead and engage teams through high pressure situationsAppetite for technology, standardization and leveraging automation, where possibleStrong written and verbal communication with experience presenting to internal leadership and (desired) external clients/stakeholdersStrong ability to lead through influence and secure cross-functional commitments to deliver key items on the audit roadmapAbility to travel 15%Physical/Cognitive Requirements:
Ability to remain seated in a stationary position for prolonged periods.Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, computer and other office-related equipment.No heavy lifting is expected, though occasional exertion of about 20 lbs. of force (e.g., lifting a computer / laptop) may be required.Ability to interact with leadership, employees, and members in an appropriate manner.
