Quality Auditor Jobs

Job Title: Claims Quality Auditor Company: Location: Tampa, FL Description: Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience. Role: Service Operations Claims Specialist Assignment: Processing Location: Are you a fit? Do you enjoy providing exceptional customer service? Would you like to interact with Humana's customers to help diagnose and resolve their problems and concerns? Assignment Capsule In this highly visible role as a Claims Specialist, we look to your experience, enthusiasm, and unrelenting customer focus to help us achieve high levels of customer service excellence as you educate and problem solve for our members, providers and employers regarding insurance-related health care issues. Processing member claims Making outbound phone calls to members or providers to get required information for processing. Investigating claims for required processing information. Key Competencies Build Trust: You honor your word by doing what you say you are going to do. Champions the Customer: You keep closely attuned to the needs and perspectives of customers and use this insight for the benefit of the business. Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition. Is Accountable: You meet clearly stated expectations and take responsibility for achieving results. Role Essentials High School Diploma Proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access Related work experience Commitment to preserving confidentiality Reporting Relationships You will report to a Frontline Leader. This area is under the leadership of the SVP & Chief Operating Officer. Additional Information Minimum Education Required: High School Years of Experience Required: At Least 1 Year Expected Travel Time: None

Job Title: Senior Quality Auditor Company: Location: Pinellas Park, FL Description: We need an individual with experience in the medical device field, knowledge of quality/regulatory requirements, previous experience working in a supply chain management environment and project management experience. ' The ideal candidate will be required to travel approx. 1week out of every month. ' Project will review current supplier classifications and determine appropriateness based on regulatory requirements and Baxter standards and business concerns. ' Conducts on-site and off-site assessments of raw materials/components and service suppliers using applicable company procedures, applicable country regulations, directives, standards, inspection guidelines and compendia as requirements. ' Knowledge and maintenance of pertinent standards including but not limited to: 21 CFR Part 820, ISO9001:2000, Medical Device Directive, ISO13485:2003, Canadian Medical Device Regulation. ' Plans and develops risk assessment strategies for supplier quality approval and monitoring. ' Reports project progress (verbally and written) to management. ' Remains current in regulatory trends. ' Able to work independently and be flexible to changing priorities. ' Must have 5+ years experience in the areas of GMP regulations that pertain to Medical Device Mfg. ' Previous auditing experience and ASQ, RAB or other recognized auditor accreditation is required.

Job Title: Quality Assurance Auditor Company: Polaris Industries Location: Osceola, WI Description: Position Description Requisition Number 08-0195 Job Title Quality Assurance Auditor Polaris Location Osceola, WI State WI Department 972 - 1st Shift, Plant 2 Building Employment Status Full-time Job Description JOB SUMMARY: To ensure that all products shipped to the consumer meet or exceed that consumer's expectations. To aid other departments in the organization in improving the function and performance of all aspects of our business. To audit and verify critical processes in the manufacture of Polaris products. Reporting of audit findings in a professional and accurate manner to facilitate improvement in quality, productivity and safety. ESSENTIAL DUTIES & RESPONSIBILITIES: 1. Support production by teaching operators how to correctly use gauges and other quality equipment. 2. Audit various process characteristics per specification plans, may include but is not limited to: Receiving inspection of components or raw materials WIP Quarantined inventory Re-worked components or assemblies Finished goods audits 3. Make necessary recommendations for process improvements. 4. Perform sort of non-conforming materials as required. 5. Verification of Manufacturing Department materials and parts, assuring that they meet written specifications within established tolerances. 6. Work overtime or vary working hours as needed. 7. Attend company provided training. 8. Work with measuring and production tools 9. Cross train in other quality positions to back-up or assist other quality personnel as necessary. 10. Prepare layout sheets, prepare RMO's, shipping orders and order supplies for QA Lab as necessary. 11. Challenge nonconforming product using proper chain of command and hold tag procedures. 12. Provide help with rework projects as the quality inspector for all completed rework. 13. Maintain or input quality data/files as required. May include but is not limited to: QA files PPAP Audit results FAIR's RMO's Deviations PQR's FTQ PP100 14. Communicate to appropriate personnel any necessary issues, findings, etc. 15. Maintain quality inspection equipment as necessary. 16. Provide input into improving existing inspection procedures and actively participate in the PCI process. 17. Work in safe and healthy manner, strictly following all safety rules and regulations 18. Perform duties outside assigned area, as required. 19. Maintain a neat and organized work area. SKILLS & KNOWLEDGE 1. High School Diploma or equivalent required. 2. Technical diploma or equivalent training preferred. 3. Must be familiar with parts, tolerances, dimensions, problem areas, various inspection equipment, and quality terminology. 4. Must have a performance history of quality conscious work, good attendance and safe work habits. 5. One year experience with basic gauging equipment (micrometers, calipers, height gauges, etc.) required. 6. Must have experience and a strong working knowledge of the production area this position is assigned to support (i.e. seats, engines, metal fabrication, etc.) 7. Must have flexibility to cover other shifts when needed. 8. Must have a working knowledge of PC software programs (i.e. word processing, spreadsheets, database, email) including the ability to enter and retrieve data. 9. Must have working knowledge of the AS400 system. 10. Must have strong oral and written communication skills. 11. Must be able to manage conflict and solve problems independently. 12. Must have demonstrated organizational and leadership skills. 13. Must be responsible, enthusiastic, trustworthy, and able to work with minimum supervision. 14. Previous inspection experience or related education preferred. WORKING CONDITIONS See Human Resources *** when applying say you found this position on WisconsinJobNetwork.com ***

Job Title: QA Auditor Company: Location: Vienna, VA Description: At Covance, you can make a difference by helping to deliver life-saving and life-enhancing medicines to people around the world. Our commitment to this mission has resulted in Covance’s impressive history of company stability and growth. We’ve achieved these results by fostering a work environment that encourages, develops and leverages our team’s capabilities. Covance’s ongoing success offers team members unsurpassed growth and career development opportunities. There is no better time to join us! As a QA Auditor at Covance you’ll ensure compliance with applicable Standard Operating Procedures (SOPs) and regulations by performing internal protocol, data, report, in-lab phase inspections, and supplemental audits in a technical discipline (e.g., Mammalian Toxicology, Drug Metabolism, Bioanalytical Chemistry and Pharmaceutical Analysis). Additional responsibilities may include: Act as liaison between QA and other departmental staff toward successful study completion. Performs internal supplemental audits of a technical discipline to verify that facility records (e.g., equipment, training files) are in conformance to applicable SOP and regulatory requirements. Performs internal protocol, data, report, and in-lab phase inspections in a technical discipline to verify conformance to applicable SOP and regulatory requirements. Identifies and participates in process improvement and ensures QA systems are properly maintained. Evaluates responses to inspection reports and performs follow-up with respondents, management, or others, if needed, to ensure resolution. Participates in client introductions, tours, and client audit debriefs. Assists with client audits by retrieving and preparing study data and facility records needed for review. Education: BS/BA degree in a science related field is required or two years applicable experience may be substituted with an Associates degree. Proficiency with Microsoft Office applications. Covance offers an outstanding benefits package including medical & dental insurance, tuition reimbursement, a 401(k) plan with a generous company match, and a generous paid time off allowance - all of which are effective on the first day of employment! At Covance, we help make the miracles of medicine a reality. We offer opportunities to work on diverse, challenging projects with bright, interesting colleagues while building a flexible and rewarding career. Covance is committed to diversity in the workplace and is an equal opportunity employer. (M/F/D/V). Your confidentiality and privacy are important to us.

Job Title: Clinical Quality Auditor Sr-33264 Company: WellPoint Location: Columbia, SC Description: WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide. Responsible to ensure clinical quality through an audit process. Primary duties may include, but are not limited to: Conducts on-site audits of prospective and existing physicians and independent practice groups for inclusion in networks. Ensures that both utilization and quality programs meet criteria. POSITION MUST BE LOCATED IN SOUTH CAROLINA, may work from a home office or the Columbia location. Must have a current Registered Nurse (RN) license (state specific), a Bachelor's Degree in health sciences, health management or related field with a minimum of 5 years experience in utilization management, quality assurance and/or plan administration, or any combination of education and experience, which would provide an equivalent background.

Job Title: Quality Auditor Company: Plastipak Packaging Inc. Location: East Longmeadow, MA Description: Responsible for performing required quality testing, documenting and analyzing datea to ensure product is in complete compliance with customer specifications. Must have excellent people skills to be able to work with and train production associates and put non-conforming product on hold. Most new hires will be assigned to night shifts after a training period on days. These are 12 hours shifts - Monday, Thursday and Friday one week and Tuesday, Wednesday, Saturday and Sunday the next.

Job Title: Quality Auditor - Scientific Company: Yoh Scientific Location: Elkton, VA Description: Remember when your career dreams were limitless? They can be again when you work with Yoh Scientific. Our customers look to Yoh Scientific to deliver talent with fresh ideas and empowered minds who want to fulfill their potential. People like you. Yoh Scientific has a contract opportunity for a Quality Auditor to join our customer in Lakewood, NJ. Responsibilities: • This position requires an individual to review production batch records for cGMP compliance and to meet Merck requirements. • Will be assigned to support Organic Synthesis Active Pharmaceutical Ingredient manufacture. • Also required to do housekeeping audits of the area and metrics reporting for the area. • Will report to the Quality Assurance Manager for APIs. • Hours: 8 am – 5 pm. Qualifications: • BS in Biology, Chemistry, Chemical Engineering or related field is required. • Knowledge of GMPs is required. • Minimum of 2 – 3 years of experience working in a GMP environment is strongly desired. • Strong communication and problem solving skills. • Must have basic computer knowledge and the ability to use Microsoft products – (Outlook, Word, Excel, Access). Discover all that’s possible with Yoh Scientific. Apply now. Partnering with Yoh In addition to great career opportunities, consulting with Yoh comes with its perks: • Competitive compensation plans • Wide variety of benefit options • Yoh Advantage - our consultant rewards program that offers discounts and perks at leading companies and with national brands exclusively for Yoh About Yoh Yoh is one of the largest providers of talent and outsourcing services to customers in the United States. With over 374 million USD in total sales, Yoh operates from more than 75 locations and provides long- and short-term temporary and direct placement of technology and professional personnel, as well as managed staffing services, for the information technology, scientific, engineering, health care and telecommunications communities. For more information, visit yoh.com . Yoh is part of Yoh Services LLC, a Day & Zimmermann Company.

Job Title: Facility Data Quality Auditor Company: Kaiser Permanente Location: Redwood City, CA Description: This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and Licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer. DEPARTMENT: EIO, AUDITING AND TRAINING The physical work location is at Redwood City Medical Center. SCHEDULE: Full-time regular; 40 hours per week; Day Shift; Monday through Friday; 08:30AM - 05:30PM. POSITION SUMMARY: Under minimal supervision, ensures accurate and appropriate documentation through local coaching and monitoring. Provides documentation coaching to clinicians in the Outpatient Clinic and Emergency Department. Monitors success of coaching and training efforts through encounter audits which ensure documentation meets requirements for diagnosis and E&M assignment, based on Official ICD-9-CM Documentation Guidelines. EDUCATION/LICENSE/CERTIFICATION: BS (Business Administration, Health Care, Public Health, Finance, Business Medical Records Technology) or equivalent experience. Certification in one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC). QUALIFICATIONS: Significant experience coding (3 or more years) based on Coding Clinical Guidelines for inpatient and outpatient. Demonstrated experience conducting Medical Record audits and ability to interpret and apply Federal and State regulations, coding and billing requirements. Demonstrated project management experience including design and implementation of audit plans. Demonstrated ability to constructively and sensitively provide feedback to providers and medical center leadership regarding federal and state coding, medical documentation and compliance guidelines, audit results and risk areas. Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data. Strong interpersonal and excellent written, verbal and presentation skills. Demonstrated ability to work independently with minimal supervision. Demonstrated ability to work within a team environment. Willingness to be flexible depending upon department and/or physician schedule needs. Demonstrated ability to review analytical data and audit findings to identify documentation trends and other risk areas. Demonstrated ability to develop data requirements and work with analytical groups to extract, organize and analyze coded data. Must be able to work in a Labor / Management Partnership environment. PREFERRED QUALIFICATIONS: Experience using PC applications such as MS Word, Excel, Access, PowerPoint. Medical center operations or clinical experience. SKILLS TESTING: N/A DUTIES: Using independent judgment and sensitivity, coaches individual physicians, reviewing their audit findings, making suggestions for documentation improvements and updating on changes to Federal and State government billing and coding guidelines. Partners with Trainer in the development of future training that will address documentation risk areas identified through local and regional audits. Plans, schedules and performs encounter audits to monitor performance and ensure lasting improvement. Encounter audits will be the primary monitoring tool used to identify operational and regulatory issues related to coding, documentation, and compliance requirements and to ensure complete and accurate data capture in compliance with Federal and State requirements. Monitors corrective actions for audit review findings. Serves as a local resource in meeting internal and external regulatory requirements (e.g., Centers for Medicare & Medicaid Service (CMS), National Committee for Quality Assurance (NCQA)). Actively participates with local CMS (Center for Medicare/Medical Services) team to ensure local objectives are met and regional CMS compliance activities are supported. Works with medical center leadership to provide confidential audits and feedback on an “as needed” basis. Assists in the identification of operational processes that hinder encounter data capture. Enters encounter audit results into regional audit database to support quality assurance process, regional analysis and regional training activities. Prepares and/or performs medical center auditing analysis and/or special projects as assigned. Partners with Data Quality Trainer and other local analytical workgroups to identify audit trends and risk areas based on audit findings and data analysis. Assists in developing and implementing policies and procedures / Compliance Audit Standards to ensure compliance with Federal, State and other regulatory requirements. NOTE: Travel between Medical Center facilities may be required. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente's policies and procedures. Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees. - Kaiser Permanente is an AA/EEO employer.

Job Title: Facility Data Quality Auditor Company: Kaiser Permanente Location: San Francisco, CA Description: This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and Licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer. DEPARTMENT: EIO, AUDITING AND TRAINING The physical work location is at San Francisco Medical Center. SCHEDULE: Full-time regular; 40 hours per week; Day Shift; Monday through Friday; 08:00AM - 05:00PM. POSITION SUMMARY: Under minimal supervision, ensures accurate and appropriate documentation through local coaching and monitoring. Provides documentation coaching to clinicians in the Outpatient Clinic and Emergency Department. Monitors success of coaching and training efforts through encounter audits which ensure documentation meets requirements for diagnosis and E&M assignment, based on Official ICD-9-CM Documentation Guidelines. EDUCATION/LICENSE/CERTIFICATION: BS (Business Administration, Health Care, Public Health, Finance, Business Medical Records Technology) or equivalent experience. Certification in one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC). QUALIFICATIONS: Significant experience coding (3 or more years) based on Coding Clinical Guidelines for inpatient and outpatient. Demonstrated experience conducting Medical Record audits and ability to interpret and apply Federal and State regulations, coding and billing requirements. Demonstrated project management experience including design and implementation of audit plans. Demonstrated ability to constructively and sensitively provide feedback to providers and medical center leadership regarding federal and state coding, medical documentation and compliance guidelines, audit results and risk areas. Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data. Strong interpersonal and excellent written, verbal and presentation skills. Demonstrated ability to work independently with minimal supervision. Demonstrated ability to work within a team environment. Willingness to be flexible depending upon department and/or physician schedule needs. Demonstrated ability to review analytical data and audit findings to identify documentation trends and other risk areas. Demonstrated ability to develop data requirements and work with analytical groups to extract, organize and analyze coded data. Must be able to work in a Labor / Management Partnership environment. PREFERRED QUALIFICATIONS: Experience using PC applications such as MS Word, Excel, Access, PowerPoint. Medical center operations or clinical experience. SKILLS TESTING: N/A DUTIES: Using independent judgment and sensitivity, coaches individual physicians, reviewing their audit findings, making suggestions for documentation improvements and updating on changes to Federal and State government billing and coding guidelines. Partners with Trainer in the development of future training that will address documentation risk areas identified through local and regional audits. Plans, schedules and performs encounter audits to monitor performance and ensure lasting improvement. Encounter audits will be the primary monitoring tool used to identify operational and regulatory issues related to coding, documentation, and compliance requirements and to ensure complete and accurate data capture in compliance with Federal and State requirements. Monitors corrective actions for audit review findings. Serves as a local resource in meeting internal and external regulatory requirements (e.g., Centers for Medicare & Medicaid Service (CMS), National Committee for Quality Assurance (NCQA)). Actively participates with local CMS (Center for Medicare/Medical Services) team to ensure local objectives are met and regional CMS compliance activities are supported. Works with medical center leadership to provide confidential audits and feedback on an “as needed” basis. Assists in the identification of operational processes that hinder encounter data capture. Enters encounter audit results into regional audit database to support quality assurance process, regional analysis and regional training activities. Prepares and/or performs medical center auditing analysis and/or special projects as assigned. Partners with Data Quality Trainer and other local analytical workgroups to identify audit trends and risk areas based on audit findings and data analysis. Assists in developing and implementing policies and procedures / Compliance Audit Standards to ensure compliance with Federal, State and other regulatory requirements. NOTE: Travel between Medical Center facilities may be required. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente's policies and procedures. Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees. - Kaiser Permanente is an AA/EEO employer.

Job Title: Research Quality Assurance GCP Auditor Company: Abbott Laboratories Location: Milwaukee, WI Description: Position Description This position is located in Abbott Park, IL - but we are recruiting out of Southeastern Wisconsin for qualified candidates. Job Title Research Quality Assurance GCP Auditor AutoReqId 52249BR Job Family QUALITY ASSURANCE Job Category Full-Time Job Classification Experienced Division Global Pharmaceutical R and D Shift. First Job Description Responsible for assessing quality systems/scientific reports and clinical data; conducting internal and external audits of clinical investigator sites, contract research organizations and vendors. Will generate audit reports and render quality assurance presentations to Abbott affiliates, clinical investigators, and R&D personnel. This position may be filled at a lower grade based on experience. Skills/Experience Requirements 1-2 years QA auditing experience, GCP (Good Clinical Practice) auditing experience is preferred. 2-5 years Quality Assurance or experience within a clinical research organization. Familiarity with current and pending FDA regulations, 21 CFR and ICH Guidelines. Render training presentations on regulations, compliance and quality related subjects as requested. Maintain liaison with all appropriate interdivisional and intra company departments and teams to ensure expeditious completion of projects and corrective action for audit observations. Education Requirements Bachelor’s degree in a physical science, life science, nursing, pharmacy. Significant Work Activities & Conditions Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day) Percentage of Travel 30-40% Country USA State/Province/Region Illinois Site Location: For corporate headquarters positions, please select Abbott Park,IL and Lake County,IL Lake County,IL *** when applying say you found this position on WisconsinJobNetwork.com ***