Sr. Manager, Quality Audit

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 risk
• Regularly “test the system” for audit readiness to proactively identify gaps
• Ensure organization is knowledgeable on audit evaluation criteria and partner with training, product, operational teams and clinical teams to ensure readiness to meet audit criteria
• Coordination with training, clinical operations and quality and operational leadership to train on knowledge gaps identified through tracers
• Drive toward automation for Included Health’s “standard” audits
• Ensure our audit methodology is compliant


• Audit Coordination and Support:
• Drive creation of materials utilized in audits- both internal and customer-facing
• Create audit plan, which will include roles and responsibilities, timeline, tasks, risks, issues and goals
• Schedule and run internal meetings associated with an audit
• Pull relevant audit data as defined by audit requirements (e.g. calls, chats, cases, etc.)
• If onsite, coordinate catering and customer transportation
• Send leadership/executive status updates leading up to and during audit
• Orchestrate 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 timelines
• Document audit findings in an executive summary which will include recommendations for operational, clinical, product and technology teams
• Support Client Success Executive in post-audit activities


• Leadership:
• Regular communication with Senior Leadership on audit status and project plans
• Oversee Quality Audit Specialist (s) to execute on day to day program activities
• Responsible for the career development of Quality Audit Specialist team

Required Qualifications:

• Bachelors Degree
• 3+ years working for a benefit consultancy firm OR, 3+ years working in healthcare or healthcare adjacent internal audit readiness
• 5+ years project management experience - specifically managing cross functional projects
• 5+ years leadership experiencing managing project managers and/or audit consultants
• 2+ experience working with healthcare data and/or quality metrics
• Ability to lead and engage teams through high pressure situations
• Appetite for technology, standardization and leveraging automation, where possible
• Strong written and verbal communication with experience presenting to internal leadership and (desired) external clients/stakeholders
• Strong ability to lead through influence and secure cross-functional commitments to deliver key items on the audit roadmap
• Ability 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.

The United States new hire base salary target ranges for this full-time position are:
Zone A: $118,640 - $167,580 + equity + benefits  Zone B: $130,504 - $184,338 + equity + benefits  Zone C: $142,368 - $201,096 + equity + benefits  Zone D: $154,232 - $217,854 + equity + benefits  
This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.
Starting base salary for the successful candidate will depend on several job-related factors, unique to each candidate, which may include, but not limited to, education; training; skill set; years and depth of experience; certifications and licensure; business needs; internal peer equity; organizational considerations; and alignment with geographic and market d