UM Quality Analyst/Lead

Role Description

The Quality Assurance Analyst plays a key role in organizing and facilitating the development of strategic programs, providing thorough analysis of existing processes and their implementation. This position is responsible for researching, compiling, and presenting relevant data and feedback related to risk activities.

• Conducts quality assurance audits of completed prospective and concurrent reviews for inpatient, outpatient, ambulatory, and ancillary services, ensuring accurate documentation, adherence to processes, and maintenance of quality standards.
• Designs and delivers targeted educational sessions for team members concerning policies, procedures, and benefits, as appropriate.
• Maintains comprehensive knowledge of business operations, products, and corporate organizational structure, including functional responsibilities.
• Performs quality audits of inbound and outbound calls, confirming that all informatio...