The Quality Audit Program Manager is responsible for developing a dedicated and centralized audit function to support client audits of Included Health’s care and services. This is a new role and will be both a leader and individual contributor. This role will 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 Quality Audit Program Manager will report to the Director of Service Quality.

Responsibilities:

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Continuous readiness

• Develop and 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

Experience/Skills:

• 2+ years working for a benefit consultancy firm, within the clinical audit function OR, 2+ years working in healthcare or healthcare adjacent in internal clinical audit readiness
• 2+ years project management experience - specifically managing cross functional projects; preference is non-technical projects (would want to see examples of project management documentation)
• Inclusive style that brings people together to effectively meet shared goals
• Ability to lead and engage teams through high pressure situations
• 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
• VERY detail oriented
• Ability to adapt to a changing environment
• Takes ownership
• Curious nature- wanting to dig in and understand root causes of problems

Preferred Education:

• Registered Nurse

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About Included Health

Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com.

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Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.