We are looking for a detail-oriented and analytical USRN QA Specialist to ensure quality and compliance in Utilization Review/Utilization Management processes. This role plays a critical part in maintaining high performance standards and driving continuous improvement across healthcare operations.
Conduct quality audits and evaluations of Utilization Review/Management cases
Ensure compliance with client standards, clinical guidelines, and regulatory requirements
Provide actionable feedback, coaching, and recommendations to improve performance
Analyze QA trends, identify gaps, and support process improvements