Quality Management Specialist (Remote) 2025-1418

Company: Managed Care Advisors
Location: Atlanta
Posted on: April 1, 2025

Job Description:

Position Title: Quality Management Specialist (Remote) 2025-1418 Location: Atlanta, GA, USA Job Category: Operations Job Type: Full Time Description: Quality Management SpecialistRemote Quality Management Specialist - Open to Nationwide ApplicantsSalary range $55,000-$78,000Are you passionate about ensuring quality and compliance in a dynamic environment? Join SGS as a Quality Control Analyst (QCA) and play a crucial role in supporting our Quality Management System (QMS) for a high-profile client.The Quality Management Specialist (QMS), you will work from your home office from Monday to Friday, 8AM - 5PM Eastern Time and be part of a collegial team that is responsible for supporting the Quality Management System (QMS) for a high-profile client. This role involves both clinical and non-clinical tasks to ensure compliance with QMS and client contracts. The QMS identifies requirements and creates processes to ensure consistent and reliable execution of work. They coordinate the creation of controlled documents such as Standard Operating Procedures and Work Instructions, perform audits to meet performance metrics, and address internal and client concerns. Additionally, the QMS tracks and mitigates risks, facilitates continual improvement by leading improvement projects, and supports contract managers and the analytics team in preparing quality assurance reports.Duties and ResponsibilitiesProvides input to SGS managers and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols.Assist with collection and summary of data in collaboration with SGS Quality Committees, identifies opportunities for improvement, and presents findings.Understands each contract's clinical quality assurance requirements and monitors compliance, in collaboration with the SGS analytics and management teams.Monitors and analyzes clinical outcomes in relation to goals and contractual requirements, in collaboration with the SGS analytics and management team.Performs standard and ad hoc audits of case management activities, as directed by quality committees.Provides feedback and coordination of improvement of quality tools, such as audit checklists and instructions.Assists in the identification of program deficits and coordinates team training and monitoring of corrective actions.Assists with performance improvement activities.Tracks client complaints and issues to resolution, in collaboration with the Account Managers.Identifies new areas that need quality monitoring, on a short-term or continuous basis.Assists in activities to prioritize improvement initiatives.Investigates and incorporates national best-practice interventions into SGS processes in conjunction with clinical management.Ensures that documentation produced and/or processed complies with federal regulations and contractual requirements.Assumes responsibility for related duties as required or assigned.QualificationsBachelor's or Master's Degree preferred in Healthcare, Nursing, Health Administration, or a related fieldRegistered Nurse, licensed in any state, with national certification in a relevant fieldMinimum of 1-2 years experience with quality improvement, corrective action, auditing, and/or staff educationFamiliarity with government contracting and requirements preferred.Demonstrated ability to ensure quality deliverables in accordance with the PWS, and to ensure that all required performance standards are metExperience with nursing and/or vocational rehabilitation case management in the FECA or other workers compensation arena preferred.A proven track record in meeting deliverable schedules and performance requirements for programs of a similar size and scope is required.Attention to detail, timetables, and commitment to completing tasksProficiency in computer use, including Microsoft Office Word, PowerPoint, Excel, and Outlook, strong analytical skills in interpreting data, and the ability to multi-task effectively.Well organized, efficient, and able to work independently and within a teamReliable High-Speed Cable or Fiber Optic Internet service and Internet Router in established home officeExcellent Communication Skills via Phone, E-Mail, Text, Verbal, Documentation Skills, ability to create and complete comprehensive, accurate, and constructive written reportsAbility to pass a preliminary credit and background checkAbility to obtain and maintain public trust federal security clearance(s)Ability to travel as requiredFor a career path that is both challenging and rewarding, join Sedgwick Government Solution's talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assets, their employees, and their customers. At Sedgwick Government Solutions, caring counts--. Join our team of creative and caring people of all backgrounds and help us make a difference in the lives of others.Sedgwick Government Solutions provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of a specific location. A comprehensive benefits package is offered including, but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.To be considered for this position, please submit a resume, and complete the application.The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required.Important InformationSuccessful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire. Search Firm Representatives Please be advised that Sedgwick Government Solutions (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions.Government Solutions strives to make our career site accessible to all users. If you need disability-related accommodation for completing the application process, please contact Government Solutions regarding accommodations. Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action EmployerAll qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person's relatives, friends or associates.Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.About SedgwickSedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy - Sedgwick Terms and Conditions - SedgwickPI7a4e5d62ff51-25660-37209962

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