What you will do:

•  Audit calls and cases based on the frequency established by our metrics. Evaluate performance and ensure policies, positioning, and all standard operating procedures are followed
• Review casework to evaluate performance and ensure policies, positioning, and all standard operating procedures are followed
• Share trend analysis & any QA concerns; develop initiatives to support reducing the frequency of these concerns
• Conduct routine audits and report trends/ improvement opportunities to all stakeholders
• Partner with the Leadership, Operations, and Training teams to recommend continuing education for Care Navigation teams
• Create, manage, and maintain dashboards and trackers to provide visibility of performance and call/case drivers to the organization, aiding in process improvement
• Own the creation and editing of policy and procedure articles, assist in ensuring education materials for our teams are appropriate and current
• Participate in long-term planning and scoping of the QA initiative.
• Support the Care Navigation team as needed

What you will bring:

• Master’s degree in clinical social work or equivalent; LCSW or equivalent independent clinical licensure is required (e.g. LMFT, LPC, LPCC, etc)
• Demonstrated proficiency in Excel and Google Sheets
• Strong attention to detail
• Effective time management, ability to handle high-volume daily workload efficiently
• Strong analytical skills – ability to work with data and develop insights
• Strong communication, interpersonal, and presentation Skills
• Empathic communicator with a consultative approach, able to see things from another individual’s point of view
• Clinical knowledge (in assessment and safety planning) and 2 years of experience with high risk clients.
• Understanding of organizational policies and procedures 

Nice to have:

• 2+ years experience as a Quality Assurance Specialist or experience document process and procedure, evaluating and scoring member calls
• Experience in Quality Management Software, Confluence, Google Suite (Drive, Sheets, Presentations, Lucid Charts) strongly preferred
• Familiarity with NCQA accreditation