Clinical Quality Consultant

Job Summary

Providing strategic direction for clinical quality improvement, the full-time Clinical Quality Consultant will work remotely to lead accreditation processes, analyze member care quality, and develop innovative solutions to enhance compliance and performance metrics.

Key responsibilities:

• Lead accreditation survey submission processes and coordinate evidence for accrediting bodies
• Collaborate with internal partners to identify quality improvement opportunities and implement accreditation best practices
• Monitor clinical effectiveness and develop performance reports to maintain accreditation compliance

Required qualifications:

• 3+ years of experience in managed care and health plan quality regulatory requirements
• 2+ years of experience in preparing and submitting URAC or NCQA accreditation surveys
• Solid knowledge of clinical quality and regulatory compliance in managed care
• Proficiency in Microsoft Office applications and AI tools like Microsoft Copilot
• Excellent time management and prioritization skills