Avalon Administrative Services LLC is looking for Quality Improvement Specialist in East Lake-Orient Park, FL.
This local job opportunity with ID 3939516967 is live since 2026-11-03 17:21:59.
Facilitates quality improvement activities by auditing claims data, identifying performance variation, coordinating root-cause analysis, and developing and evaluating improvement plans. Partners with clinical policy, claims, coding, and other teams and supports committee oversight and annual quality work plans. Remote work is eligible, with quarterly travel to the Tampa, Florida corporate office. Manage quality audits, analyze claims data, and recommend, implement, and evaluate improvements. Review analytics and claims results to identify inconsistencies and quality concerns. Deliver monthly and quarterly audit findings and recommendations. Monitor quality work plan metrics, identify variations, and lead root-cause analysis with relevant teams. Develop, update, and evaluate the annual Quality Improvement Work Plan. Prepare Quality Improvement Committee agendas and materials and document committee activities. Claims data analysis Quality auditing Healthcare quality improvement Quality metric monitoring Root-cause analysis Performance measurement Improvement plan development Medical policy interpretation Claims payment policy review Committee documentation Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) and/or Certified Professional Medical Auditor (CPMA)5c143e31-5e48-4549-b638-05792d185386
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