Quality and Process Improvement Lead

Dane Street

. Serve as the bridge between internal operations and clients, ensuring compliance with client parameters and quality standards .

Posted 10/2/2026full-timeRemote • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality assurance and auditing within healthcare operations, with a strong focus on compliance, data analysis, and process improvement. Proficient in collaborating with cross-functional teams to enhance operational efficiency and client satisfaction.

Highest-signal resume keywords

Quality AssuranceAuditingData AnalysisProcess ImprovementClient Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality Metrics AnalysisRoot-Cause AnalysisScoring MethodologiesEvidence-Based GuidelinesUtilization ReviewCAPA ProtocolsAudit MethodologiesMachine Learning ValidationTrend IdentificationDocumentation

Soft Skills

Strong Communication SkillsAttention to DetailCoaching AbilityAnalytical SkillsIndependent Management

Tools & Technologies

Microsoft OfficeAudit SystemsCase-Management SystemsClient Portal

Industry Keywords

Healthcare OperationsWorkers’ CompensationClinical GuidelinesQuality StandardsCompliance

About the role

Key responsibilities & impact

Serve as the bridge between internal operations and clients, ensuring compliance with client parameters and quality standards
Partner with client auditors through monthly review calls and calibration sessions
Manage monthly case sample selection, score logging, and deduction-point tracking in the client portal
Lead audit rebuttals by investigating findings and presenting data-backed appeals
Maintain, analyze, and upload quality metrics and audit insights to the client portal
Lead in-person client touchpoints and strategic business reviews
Facilitate coaching sessions for the internal QA team
Analyze audit trends, identify root causes, and recommend process solutions
Oversee post-audit action plans and implementation of process updates and machine-learning enhancements
Collaborate with Machine Learning, client, and operations teams to develop automation rules
Validate machine-learning automations and tool features against live sample data
Conduct internal QA calibration sessions to eliminate scoring variances
Document audit methodologies, case guidelines, and client-specific rules in SOPs
Design CAPA protocols for recurring high-severity errors and compliance failures
Establish reporting cadence for executive leadership covering risks, solutions, and performance gains

Requirements

What you’ll need

Associate's Degree or Equivalent Experience
Experience in quality assurance, auditing, utilization review, or a related healthcare operations function
Working knowledge of workers’ compensation utilization review processes and requirements
Ability to interpret and apply client-specific requirements, audit criteria, scoring methodologies, and quality standards
Strong working knowledge of evidence-based and jurisdiction-specific clinical guidelines and criteria, including ODG, MTUS, and other applicable state-specific treatment guidelines
Strong analytical skills, including trend identification, discrepancy investigation, and root-cause analysis
Ability to translate audit findings and data into practical process improvements and corrective actions
Experience providing quality feedback, coaching, or education to operational teams
Strong written and verbal communication skills
Strong attention to detail and ability to independently manage recurring audits, deadlines, documentation, and follow-up activities
Proficiency with Microsoft Office and reporting, audit, and case-management systems
Ability to collaborate across Operations, Quality, Technology, and other functional teams
Ability to travel up to 10%
3+ years’ experience working with the client(s) the role will support in a QA function (preferred)
Ability to supply and support personal internet services for remote work
Uninterrupted internet connection required for work from home

Benefits

Comp & perks

Medical, dental, and vision coverage for employees and families
Voluntary life insurance for employees, spouses, and children
Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans
Basic life insurance at no cost
Short-term disability coverage at no cost
Long-term disability coverage at no cost
Generous paid time off
401(k) plan with company match
Apple equipment for remote workspace
Media stipend for remote workspace
Collaborative remote culture
Professional growth opportunities
Comprehensive benefits
Commitment to employee development