Job Closed
This listing is no longer active.
VSP Vision is a doctor-governed, not-for-profit vision benefits company that consists of business segments that collectively offer eye care insurance, eyewear,
Senior Provider Quality Auditor
Location
United States
Posted
73 days ago
Salary
$63K - $108K / year
Seniority
Senior
No structured requirement data.
Job Description
Senior Provider Quality Auditor
VSP Vision
Support leadership with the coordination, implementation, and oversight of all facets of the Quality Management Program. Facilitate medical record audits, research complaints related to potential quality issues, analyze quality trends, and maintain thorough documentation of quality audits and investigations. Apply knowledge of healthcare quality standards to objectively and systematically assess provider adherence to established quality objectives and goals. Promote a culture of quality, excellence, and continuous improvement. Effectively communicate with physicians and other healthcare staff to ensure accurate, complete, and timely medical record documentation is received for quality assurance reviews Complete quality assurance reviews according to established audit schedules and procedures Obtain and review patient medical records in preparation for audit review by physician leadership and clinical reviewers Partner with clinical reviewers to educate contracted doctors and ensure compliance with appropriate standards of care, including facilitating the implementation of corrective action plans, when necessary Actively participate in quality investigations and the development/implementation of corrective action plans Inform Quality Management leadership of concerns related to corrective action plans Maintain a working knowledge of current clinical guidelines that affect quality assurance reviews and investigations Analyze audit findings to identify trends in non-compliance and present results to leadership and the Quality Management Committee Work with contracted partners to investigate and effectively resolve found quality of care and quality of service issues within established timeframes Collaborate with clinical reviewers to identify quality of care concerns and communicate corrective action plans to contracted doctors Escalate significant, recurring, or systemic quality concerns for further review and interventions Support the effective operations of the Quality Management Committee by preparing and presenting accurate reports, quality improvement work plans, interrater studies, and maintaining meeting records to ensure compliance with organizational and regulatory standards Research, analyze, and resolve complex issues and escalations related to medical record reviews, member complaints and grievances, and quality of care issues Lead end-to-end preparation and facilitation of quality assurance activities for client, regulatory, and accreditation surveys, including research audit documentation, and support of corrective action plans Maintain proper documentation of records, reports, audit findings, and corrective action plans in a manner that will allow data to be categorized, tracked, trended for analytics, and audited by clients, regulatory, and accreditation agencies Interpret and monitor quality assurance metrics to identify compliance with established quality goals, standards, and benchmarks Develop, implement, and distribute quality management policies, procedures, documents, and training materials in accordance with company standards, quality agencies, state and federal laws and regulations, and governing optometric associations’ guidelines Other duties as assigned to promote and maintain quality within the company Job Specifications Typically has the following skills or abilities: Bachelor’s degree in Business Administration, Healthcare Administration, Public Health, or other quality management-related field, or equivalent experience Minimum of four (4) years of quality assurance experience Strong knowledge of provider relations, quality management systems, and quality improvement processes preferred Excellent written, verbal, and interpersonal communication skills Ability to handle sensitive information with the highest degree of integrity, discretion, and confidentiality Self-motivated with the ability to prioritize and complete multiple complex work assignments independently and across a fast-paced team environment Highly analytical, with a knack for identifying trends, drawing conclusions, and communicating results Ability to learn complex processes, medical terminology, application systems, and identify effective business solutions through research, audit, and analysis Commitment to continuous process improvement #LI-VISIONCARE Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. Salary Ranges: $63,000.00 - $108,675.00 VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing. Unincorporated LA County Residents: Qualified Applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act, and any other similar laws. Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees. VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.
Related Guides
Related Categories
Related Job Pages
More Auditor Jobs
Senior Provider Quality Auditor
VSP VisionVSP Vision is a doctor-governed, not-for-profit vision benefits company that consists of business segments that collectively offer eye care insurance, eyewear,
Support leadership with the coordination, implementation, and oversight of all facets of the Quality Management Program. Facilitate medical record audits, research complaints related to potential quality issues, analyze quality trends, and maintain thorough documentation of quality audits and investigations. Apply knowledge of healthcare quality standards to objectively and systematically assess provider adherence to established quality objectives and goals. Promote a culture of quality, excellence, and continuous improvement. Effectively communicate with physicians and other healthcare staff to ensure accurate, complete, and timely medical record documentation is received for quality assurance reviews Complete quality assurance reviews according to established audit schedules and procedures Obtain and review patient medical records in preparation for audit review by physician leadership and clinical reviewers Partner with clinical reviewers to educate contracted doctors and ensure compliance with appropriate standards of care, including facilitating the implementation of corrective action plans, when necessary Actively participate in quality investigations and the development/implementation of corrective action plans Inform Quality Management leadership of concerns related to corrective action plans Maintain a working knowledge of current clinical guidelines that affect quality assurance reviews and investigations Analyze audit findings to identify trends in non-compliance and present results to leadership and the Quality Management Committee Work with contracted partners to investigate and effectively resolve found quality of care and quality of service issues within established timeframes Collaborate with clinical reviewers to identify quality of care concerns and communicate corrective action plans to contracted doctors Escalate significant, recurring, or systemic quality concerns for further review and interventions Support the effective operations of the Quality Management Committee by preparing and presenting accurate reports, quality improvement work plans, interrater studies, and maintaining meeting records to ensure compliance with organizational and regulatory standards Research, analyze, and resolve complex issues and escalations related to medical record reviews, member complaints and grievances, and quality of care issues Lead end-to-end preparation and facilitation of quality assurance activities for client, regulatory, and accreditation surveys, including research audit documentation, and support of corrective action plans Maintain proper documentation of records, reports, audit findings, and corrective action plans in a manner that will allow data to be categorized, tracked, trended for analytics, and audited by clients, regulatory, and accreditation agencies Interpret and monitor quality assurance metrics to identify compliance with established quality goals, standards, and benchmarks Develop, implement, and distribute quality management policies, procedures, documents, and training materials in accordance with company standards, quality agencies, state and federal laws and regulations, and governing optometric associations’ guidelines Other duties as assigned to promote and maintain quality within the company Job Specifications Typically has the following skills or abilities: Bachelor’s degree in Business Administration, Healthcare Administration, Public Health, or other quality management related field or equivalent experience Minimum of four (4) years of quality assurance experience Strong knowledge of provider relations, quality management systems, and quality improvement processes preferred Excellent written, verbal, and interpersonal communication skills Ability to handle sensitive information with the highest degree of integrity, discretion, and confidentiality Self-motivated with the ability to prioritize and complete multiple complex work assignments independently and across a fast-paced team environment Highly analytical, with a knack for identifying trends, drawing conclusions, and communicating results Ability to learn complex processes, medical terminology, application systems, and identify effective business solutions through research, audit, and analysis Commitment to continuous process improvement #LI-VISIONCARE Compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding VSP Vision benefits, please click here. Salary Ranges: $63,000.00 - $108,675.00 VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing. Unincorporated LA County Residents: Qualified Applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act, and any other similar laws. Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/Personal Information. We have been made aware that fake job opportunities are being offered by individuals posing as VSP Vision and affiliate recruiters. Click here to learn about our application process and what to watch for regarding false job opportunities. As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees. VSP Vision employees will have access to this sensitive personal information and are subject to follow Information Security and Privacy Policies.
Lead Faculty – Certification & Licensure Coordinator, MSN Direct-Entry
Herzing UniversityEstablished in 1965, Herzing University is a private, nonprofit institution committed to providing students with a "career-focused, convenient, and caring" coll
To participate in a remote work arrangement, employees must reside in the United States. No remote work arrangement will be considered for working from outside the United States. Current staff, faculty/adjunct at Herzing University: log into UKG and navigate to Menu > Myself > My Company > View Opportunities to apply using the internal application process. The role of the Lead Nursing Faculty – Certification & Licensure Coordinator will provide leadership and support for all aspects of the program related to preparing students for the Certification Exam in their specialty to maximize first time pass rates. This includes planning and delivering development to the faculty team to make certification preparation holistic in the classroom experience as well as preparing students throughout their lifespan. The role includes regular collaboration with system and campus leadership. The teaching assignment will include a preparation course in addition to other courses as appropriate. Qualifications: - Doctorate in Nursing - Online teaching experience. - Experience in NCLEX Prep - Hold an active and unencumbered WI or Compact license as a Registered Nurse - Pre-licensure nursing teaching experience preferred Compensation is determined based on the qualifications, experience, and circumstances of each hire. It is uncommon for new employees to start near the top of the salary range. We offer a comprehensive benefits package, including a tuition waiver and reimbursement program, health insurance, paid time off, and a retirement savings plan with company match. The salary range for this position is $78,030 to $105,570. Click Here or use the following link to learn more about careers at Herzing University: https://www.youtube.com/watch?v=DPDCRvjmzHM&t=3s The position's duties and responsibilities for this role include: - Teaching and learning - Scholarship of Teaching and Learning - Academic and Institutional Service Within these duties and responsibilities, the following competencies are included. - Subject Matter Expertise - Effective Communication - Pedagogical Mastery - Operational Excellence - Appreciation and Promotion of Diversity - Assessment of Student Learning - Utilization of Technology to Enhance Teaching and Learning - Continuous Improvement These competencies, as identified by the University's academic community, encompass the knowledge, skills, and behaviors essential to a faculty member's success in the classroom and provide the basis for the faculty hiring, evaluation and development process. Herzing University is committed to providing a diverse environment and is dedicated to fostering a culture and atmosphere of mutual respect. It provides an inclusive and collegial community where individuals are valued, heard and empowered to contribute to the effectiveness of the institution. Applicants must be authorized to work for any employer in the U.S. We do not sponsor or take over sponsorship of an employment Visa at this time. It is the university’s practice to recruit and hire without discrimination because of skin color, gender, religion, LGBTQi2+ status, disability status, age, national origin, veteran status, or any other status protected by law. https://www.herzing.edu/about/diversity Herzing University prohibits sex-based discrimination in any education program or activity that it operates. Individuals may report concerns or questions to the Title IX Coordinator. The notice of nondiscrimination is located at https://www.herzing.edu/title-ix.
• Planung und Durchführung von Audits bei unseren Kunden • Schreiben von Auditberichten in Deutsch oder Englisch • Sprechen von Zertifikatsempfehlungen aus • Teilnahme an erforderlichen internen Erfahrungsaustauschen
We exist to create positive change for people and the planet. Join us and make a difference too! Position: Management Systems Auditor Contract: Home-based with travel Location: South Wales - M4 corridor About The Role: As a BSI Auditor, no two days are the same! You'll meet a wide range of clients, from small independent businesses to large global superbrands. You will act as a trusted partner to your clients, supporting them through their audit process with us to achieve their ISO certifications. This role is home-based and regular travel will be required throughout South Wales. This includes travel between Bristol, Newport, Bridgend and Pembroke. Key Responsibilities: - Assess client systems and processes against ISO standards. - Prepare accurate, detailed assessment reports and clearly communicate findings and recommended corrective actions. - Provide meaningful client feedback, demonstrating strong commercial and operational understanding. - Maintain a consistent, professional, and engaging approach throughout all assessments. Essential Experience: Ideally, you will have experience in the construction and/or manufacturing industries with a good working knowledge of quality, environment and health & safety management systems and auditing. In addition, you will have: - Lead Auditor qualifications in ISO 9001, ISO 14001 and ISO 45001 - Excellent time management and prioritisation skills - Excellent communication skills - Excellent attention to detail - Full and valid UK driving licence Our Benefits: Alongside your basic salary, incentive scheme and opportunities for further development, our Auditors also receive; - A company car - 27 days holiday (plus bank holidays and the option to buy additional days) - Private healthcare - Life assurance x4 of your base salary - An excellent pension with company-matched contributions Plus, a wide range of flexible benefits that you can tailor to suit your lifestyle! BSI - Your Partner in Progress We are proud to be the business improvement company for other organisations to become more sustainable and resilient and finally to inspire trust in their products, systems, services, and the world we live in. Headquartered in London, BSI is the world's first national standards organisation with more than 125 years of experience. We are a global partner for 86,000 companies and organisations in over 193 countries, offering development, auditing, certification, and training services, including innovative software solutions and cyber security expertise for all industries: from aerospace and automotive to food, construction, energy, healthcare, IT and trade sectors. Incorporated by Royal Charter, we’re truly impartial and home to the ultimate mark of trust, the Kitemark. Through our unique combination of consulting, training, assurance and regulatory services we bring solid and broad knowledge to every company. If you want to contribute to this inspiring challenge, bring your open and enthusiastic mindset to our dynamic team, then please apply now! D&I Policy BSI is committed to ensuring the diversity of our workforce reflects that of our clients and the communities in which we operate. Our goal is to create a sense of belonging for all employees by providing opportunities to develop, grow, and engage with our global organisation all while having fun doing great work. BSI is a community where everyone can thrive. If you require any reasonable accommodations to be made on account of a disability or impairment throughout our recruiting process, please inform your Talent Acquisition Partner. #LI-SC1 #LI-Remote About Us BSI is a business improvement and standards company and for over a century BSI has been recognized for having a positive impact on organizations and society, building trust and enhancing lives. Today BSI partners with more than 77,500 clients in 195 countries and engages with a 15,000 strong global community of experts, industry and consumer groups, organizations and governments. Utilizing its extensive expertise in key industry sectors - including automotive, aerospace, built environment, food and retail, and healthcare - BSI delivers on its purpose by helping its clients fulfil theirs. Living by our core values of Client-Centricity, Agility, and Collaboration, BSI provides organizations with the confidence to grow by partnering with them to tackle society’s critical issues – from climate change to building trust in digital transformation and everything in between - to accelerate progress towards a better society and a sustainable world. BSI is an Equal Opportunity Employer dedicated to fostering a diverse and inclusive workplace.



