Clinical Quality and Compliance Coordinator

Telligen

. Coordinate quality assurance, quality improvement, accreditation, regulatory compliance, and credentialing activities across Utilization Management, Case Management, and Disease Management programs .

Posted 11/11/2026full-timeUnited StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality assurance, regulatory compliance, and credentialing within healthcare operations, with a strong focus on audit processes and quality improvement methodologies such as PDSA cycles.

Highest-signal resume keywords

Registered Nurse (RN) LicenseQuality Assurance/Quality Improvement (QA/QI)URAC Standards KnowledgeClinical Documentation ReviewPDSA Cycle Methodologies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality ImprovementCompliance MonitoringAudit ProcessesCredentialingDocumentation AuditsPerformance Measures TrackingCorrective Action PlansClinical File ReviewsAccreditation ReadinessTraining Material Development

Tools & Technologies

Audit ToolsCompliance TrackersDocumentation RepositoriesChecklistsTemplates

Industry Keywords

Healthcare OperationsAccreditationCredentialing ProcessesState Regulatory FilingsQuality Deliverables

About the role

Key responsibilities & impact

Coordinate quality assurance, quality improvement, accreditation, regulatory compliance, and credentialing activities across Utilization Management, Case Management, and Disease Management programs
Support audit activities, quality improvement initiatives, accreditation readiness, state regulatory filings, credentialing processes, and staff education
Track quality deliverables, performance measures, improvement activities, documentation, and compliance monitoring
Maintain PDSA cycle documentation and support corrective action plans
Conduct clinical file reviews, documentation audits, and compliance checks using approved audit tools
Develop, maintain, and refine audit tools, checklists, and templates under direction
Compile audit materials, document findings, analyze trends, and track issues
Maintain audit logs, compliance trackers, evidence repositories, and documentation repositories
Support URAC, NCQA, and other accreditation readiness activities
Prepare and maintain state URO applications, renewals, and amendments under direction
Support credentialing and recredentialing, primary source verification documentation, credentialing audits, and corrective actions
Develop and update staff education materials, training materials, job aids, and reference documents
Support onboarding and refresher education sessions and track training completion
Maintain policies and procedures through formatting, version control, and document management
Prepare draft reports and summaries for leadership and committee review

Requirements

What you’ll need

Registered Nurse (RN) or Licensed Practical Nurse (LPN) license
Minimum 2 years of experience in QA/QI, compliance, credentialing, or healthcare operations
Working knowledge of URAC and/or NCQA standards
Experience with clinical documentation review and audit processes
Strong understanding of quality improvement methodologies, such as PDSA cycles
Candidates living in Iowa or Maryland will be considered; internal candidates in other states may be considered
Telligen will not provide sponsorship for work authorization

Benefits

Comp & perks

100% employee-owned company with employees sharing in company success
Benefits and other compensation available; details provided in Telligen's Benefits Summary
Equal Opportunity Employer and E-Verify Participant
Reasonable accommodations during the employment process
Mission-driven, respectful, inclusive, collaborative work environment