IKS Health - Manager - Quality Audit - BPO

RESPONSIBILITIES :

- Identify, understand, and document processes and procedures surrounding internal quality controls and assurance methodologies

- Establish procedures and plan for conducting internal audits, process improvement strategies based on audit findings, and maintain a Quality Assurance Program

- Assist with preparing and updating comprehensive risk-based audit plans for evaluating the effectiveness of controls in place to manage significant risk exposures, ensure the integrity and reliability of information

- Develop testing methodologies to evaluate the adequacy of controls, identify and assess the implementation of new controls where necessary

- Continually monitor and update the assessment of the control environment, keeping abreast of significant control issues, trends and developments

- Develop and maintain audit processes and tools related to authorizations, rebuttal management, inter-rater reliability and data entry

- Document results of audits, identifying potential business process risks, if any, and develop reports and recommendations for improvement / mitigation to be presented to senior management

- Work in conjunction with Operations and Training to establish patterns or trends that require additional training, incorporating audit findings into training programs, or establishing corrective and preventive actions

- Plan, hire and manage Quality Analysts and allocate resources and individuals in accordance

- Assess technical needs and skills performance of the team and formulate professional development and educational plans to improve team efficiency

FUNCTIONAL SKILLS -

- Excellent written and verbal communication and documentation skills ability with experience interacting with and presenting to senior management-level personnel

- Strong time management, presentation and organizational skills

- Ability to build relationships while asking tough questions

- Ability to develop creative approaches and solutions necessary to solve complex problems

- Strong critical thinking and analytical skills

PROFESSIONAL SKILLS -

- Strong background and experience with audit methodologies and techniques

- General knowledge and experience with business process reviews and benchmarking

- Experience with Medical Terminology

- Working knowledge of computer proficiency required, especially with word processing, flowcharting, and spreadsheet software

EDUCATION -

Completion of a Bachelor's degree in Healthcare / Life Sciences or a related discipline required. MBA preferred.

EXPERIENCE -

Minimum of 5+ years of experience in auditing and Quality Assurance.