[Remote] Quality Auditor - Underwriting Quality Management

Remote, USA Full-time
Note: The job is a remote job and is open to candidates in USA. CVS Health is building a world of health around every individual, aiming to simplify healthcare for communities. The Quality Auditor will be part of the PBM Underwriting Quality Management Team, focusing on conducting audits, identifying improvement areas, and collaborating with various business partners to enhance quality control processes. 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 signed contract review audits and GenAI driven tools to support insights in audit workflows • 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 Skills • Bachelor's degree in Business, Finance, Risk Management, Statistics, or comparable work experience in a related field • 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 Benefits • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Company Overview • CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is Company H1B Sponsorship • CVS Health has a track record of offering H1B sponsorships, with 1 in 2022. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job
Apply Now

Similar Jobs

VP, Associate General Counsel, Healthcare Compliance and Privacy Officer

Remote, USA Full-time

Coding Analyst job at Elevance Health in Chicago, IL, Indianapolis, IN

Remote, USA Full-time

[Remote] Compliance Auditor

Remote, USA Full-time

Healthcare Auditor - Epic Resolute Hospital Billing & Chargemaster - APN Software Services, Inc

Remote, USA Full-time

Medical Coding Auditor - Risk Adjustment

Remote, USA Full-time

Compliance Officer - Medical Billing & RCM

Remote, USA Full-time

Compliance Program Specialist

Remote, USA Full-time

Lead Analyst, Advanced Provider Data Management (Remote)

Remote, USA Full-time

Sr. Government Healthcare Data Consultant

Remote, USA Full-time

Physician Consultants Wanted - Remote - Clinical, Non-clinical

Remote, USA Full-time

**Experienced Full Stack Data Entry Associate – Remote Work Opportunity at arenaflex**

Remote, USA Full-time

Coordinator, Logistics Desk- ABC News

Remote, USA Full-time

Online Survey and Data Entry Specialist (Hiring Immediately)

Remote, USA Full-time

C#/Angular Developer | Amentum | Remote (United States)

Remote, USA Full-time

Experienced Remote Data Entry Specialist (Typist) – Detail-Oriented and Tech-Savvy Professional for arenaflex

Remote, USA Full-time

Oracle Cloud Infrastructure (OCI) - Principal Member of Technical Staff/Solutions Architect - Product Development - Gen AI and AI Solutions Engineering

Remote, USA Full-time

**Experienced Customer Service Representative – Remote Cargo Agent Position at blithequark**

Remote, USA Full-time

**Experienced Customer Contact Center Representative – Remote, Eastern Time Zone – Patient Support Services**

Remote, USA Full-time

IT Project Manager III

Remote, USA Full-time

Experienced Customer Service Representative - Remote Work-from-Home Opportunity with blithequark - $24/Hour

Remote, USA Full-time
Back to Home