💼 About This Role

You'll conduct quality audits and provide coaching to improve clinical decision accuracy on inpatient reviews. You'll partner with Clinical Operations to develop training materials and SOPs. This role stands out with its fully remote setup and focus on quality improvement in a fast-growing health tech company.

🎯 What You'll Do

• Conduct quality audits of inpatient clinical determinations
• Analyze QA findings and provide actionable recommendations
• Provide coaching and feedback to improve clinical decision accuracy
• Develop and maintain SOPs, job aids, and training materials
• Facilitate onboarding and ongoing training for Clinical teams

📋 Requirements

• Active RN license
• Experience reviewing inpatient utilization management / coverage determinations
• Experience applying clinical guidelines (e.g., LCD/NCD) to medical necessity decisions
• Experience conducting quality audits or QA processes in clinical operations

✨ Nice to Have

• Familiarity with NCQA and CMS guidelines
• Experience with Google Workspace (Sheets, Docs, Forms)
• Strong analytical skills for identifying quality trends

🎁 Benefits & Perks

• 💻 Fully remote opportunity with about 5% travel
• 🩺 Medical, dental, vision, life, disability insurance and EAP
• 📈 401K retirement plan with company match; FSA/HSA
• 🏝️ Flexible Time Off + Company Holidays
• 👶 Up to 14 weeks paid parental leave

📨 Hiring Process

Estimated timeline: 2-4 weeks

1. 1Phone Screening· 30 min
2. 2Hiring Manager Interview· 45 min
3. 3Cross Functional Interview· 45 min
4. 4Leadership Interview· 45 min