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Insurance Quality Assurance Remote Jobs in Utah (NOW HIRING)

Lochner

Senior Roadway Engineer

Salt Lake City, UT · On-site +1

$98K - $134K/yr

Implement existing QA/QC procedures, participate in the further development and maintenance of the ... and remote opportunities where business needs allow * Life insurance and disability coverage ...

HMG Careers

Sales Manager Remote

Provo, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

Midvale, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

Salt Lake City, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

Saint George, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

Elberta, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Sales Manager Remote

La Verkin, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

White City, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Sales Manager Remote

Ogden, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

Kearns, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Sales Manager Remote

West Valley City, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Sales Manager Remote

Sundance, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Sales Manager

La Verkin, UT · Remote

$69K/yr

Remote Insurance Sales Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

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Insurance Quality Assurance Remote information

What is an insurance quality assurance remote?

An Insurance Quality Assurance Remote job involves evaluating and monitoring insurance processes, documents, and interactions to ensure they meet company standards and regulatory requirements—all while working from a remote location. Professionals in this role review claims, policies, and customer interactions to identify errors, ensure compliance, and recommend improvements. They often work closely with other remote teams to maintain high-quality service and prevent costly mistakes. Strong attention to detail, analytical skills, and knowledge of insurance regulations are essential for success in this position.

What are the key skills and qualifications needed to thrive as an insurance quality assurance remote professional?

To thrive as an Insurance Quality Assurance Remote professional, you need a solid understanding of insurance processes, quality control standards, and a relevant degree or background in insurance or auditing. Familiarity with claims management systems, quality assurance tools, and industry certifications such as Six Sigma or ISO are commonly required. Attention to detail, analytical thinking, and effective written communication are essential soft skills for identifying discrepancies and collaborating with remote teams. These competencies ensure consistent compliance, accuracy, and high-quality service delivery in a remote insurance environment.

What are some common challenges faced by remote insurance quality assurance professionals, and how can they be addressed?

Remote Insurance Quality Assurance professionals often face challenges such as limited direct communication with team members, staying updated on policy changes, and maintaining consistency in audit standards. To address these, it's important to leverage collaboration tools, participate in regular virtual meetings, and establish clear documentation protocols. Building strong relationships with claims adjusters and underwriters remotely also helps ensure quality standards are met and feedback is effectively shared.

What is the difference between Insurance Quality Assurance Remote vs Insurance Claims Examiner?

AspectInsurance Quality Assurance RemoteInsurance Claims Examiner
Required CredentialsCertifications in quality assurance, insurance industry knowledgeAdjuster licenses, insurance certifications
Work EnvironmentRemote, office-based, or hybridRemote or in-office claims processing
Industry UsageUsed across insurance companies for process improvementUsed by insurance companies to evaluate claims
Common Search IntentQuality assurance roles in insurance, remote QA jobsClaims processing jobs, insurance examiner roles

Insurance Quality Assurance Remote and Insurance Claims Examiner roles both operate within the insurance industry but focus on different aspects. QA roles emphasize process improvement and compliance, often remotely, while Claims Examiners evaluate individual claims, which may also be remote. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

What are the most commonly searched types of Insurance Quality Assurance jobs in Utah?

The most popular types of Insurance Quality Assurance jobs in Utah are:

What are popular job titles related to Insurance Quality Assurance Remote jobs in Utah?

For Insurance Quality Assurance Remote jobs in Utah, the most frequently searched job titles are:

What job categories do people searching Insurance Quality Assurance Remote jobs in Utah look for?

The top searched job categories for Insurance Quality Assurance Remote jobs in Utah are:

What cities in Utah are hiring for Insurance Quality Assurance Remote jobs?

Cities in Utah with the most Insurance Quality Assurance Remote job openings:

Insurance Quality Assurance Remote jobs near you

Quality Management Specialist (Healthcare) - Fully Remote

Salt Lake City, UT • On-site, Remote

MRIoA
See more jobs at MRIoAexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday

Job description

Description
Who We Are - Motivated by Purpose. Powered by Clinical Expertise.
Founded in 1983, we're a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.
Excellence starts with our people.
WE OFFER
  • A competitive compensation package.
  • Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
  • Growth and training opportunities.
  • An award-winning remote work environment

POSITION OVERVIEW
As a Quality Management Specialist, you will partner with key members of leadership for the design and implementation of Quality Management procedures, ongoing improvement efforts, and other team projects with the aim of achieving organizational, accreditation, and regulatory requirements. Based on measurement and analysis of trends, lead and support structured quality improvement initiatives (e.g., Lean, Six Sigma, DMAIC or equivalent) to reduce variation and improve performance outcomes, including reduction of errors, adverse events, or near misses and achievement of acceptable performance levels.
Roles:
  • Review and analyze current processes related to the application and implementation of policies, procedures, and practices; provide leadership with recommendations for updates to comply with the current regulatory and accreditation requirements. Identify gaps in efficient process workflow and suggests steps for quality process improvement.
  • Measure process performance using valid and accurate methods; analyze trends, variation, and process stability to determine if defined performance metrics are met and identify areas of risk.
  • Based on measurement and analysis of trends, lead and support structured quality improvement initiatives (e.g. DMAIC or equivalent) to address root causes, reduce variation, and improve performance outcomes, including reduction of errors/adverse events/near misses, or meet acceptable levels of performance.
  • Manage and lead Quality Improvement Projects (QIPs) ensuring defined problem statements, root cause analysis, measurable objectives, implementation, and validation of sustained improvement outcomes.
  • Manageand ensure execution of CAPAs, including documented root cause analysis, defined success metrics, implementation tracking, and post-implementation validation demonstrating sustained improvement in coordination with the Clinical Quality, Compliance, and Operations leaders.
  • Serve as liaison between clients and MRIoA's quality management department as needed.

Major Responsibilities or Assigned Duties:
  • Assist leadership in establishing and reporting quality metrics and lead or support structured quality improvement initiatives using structured quality improvement methodologies (e.g., Lean, Six Sigma, DMAIC or equivalent).
  • Assist with the preparation, revision, and implementation of quality management policies and procedures.
  • Perform back-end internal audits to identify and resolve quality, workflow, and production issues and use findings to inform risk prioritization, and improvement initiatives. Ensure organizational, accreditation, and regulatory requirements are achieved.
  • Address and discuss issues and proposed solutions with leadership and document activities.
  • Work closely with all departments on complying with Quality Management requirements.
  • Take part in internal testing of software updates; collaborate with Information Technology to identify and correct issues.
  • Conduct root cause analyses using structured methodologies to identify underlying drivers and ensure corrective actions address systemic causes.
  • Apply quantitative and analytical methods to evaluate process performance, identify trends, variation, and systemic drivers, and assess effectiveness of improvement initiatives.
  • Establish control mechanisms to ensure sustained improvement and process stability.
  • Quantify and communicate impact of quality initiatives (e.g., error reduction, efficiency gains, compliance improvement).
  • Collaborate with leadership to prioritize initiatives based on risk, regulatory requirements, and performance data.
  • Manage the company Quality Management System including development, maintenance, enhancements, and user support, ensuring alignment with organizational quality processes.
  • Assist with the complaint process when requested; perform audits to ensure proper handling and classification of complaints and analyze complaint data to identify risk areas and support process improvement.
  • Evaluate and document the effectiveness of quality initiatives in meeting performance thresholds and standards; report findings and recommend improvements to leadership and governance bodies as appropriate; revise ineffective initiatives as necessary.
  • Prepare and present quality performance, audit results, and quality improvement initiatives to the Quality Management Committee; support facilitation of committee activities, including preparation of materials, tracking of action items, and follow-up on assigned deliverables as requested.
  • Communicate issues or concerns relating to internal or external quality matters to department leadership.
  • Ensure client satisfaction/enhancement activities are completed, including:
  • Deliver accurate data/metrics to internal stakeholders and ensure consistent and accurate communication of metrics to clients, regulatory, and accreditation bodies;
  • Track, monitor, and report client SLA metrics; manage remediation plans and CAPAs for SLAs not met in accordance with client contractual requirements;
  • Manage and support all other client CAPAs and remediation plans.
  • Coordinate resolution of top-level issues and provide coaching to teams about Quality Management process.
  • Complete and/or aids other internal or external audits as requested.
  • Complete other duties as requested.

Requirements
Skills and Experience:
  • Minimum of 5 years' experience in a quality management role
  • Demonstrated experience applying structured quality improvement methodologies (e.g., Lean, Six Sigma, DMAIC) required
  • Working knowledge of managed care and utilization review accreditation standards, including URAC and NCQA, and multi-state regulatory requirements
  • Six Sigma Green Belt or equivalent certification preferred
  • Exceptional customer service skills
  • Exceptional analytical and critical thinking skills
  • Excellent oral and written communication skills and interpersonal skills
  • Exceptional orientation to detail
  • Excellent organizational skills
  • Ability to work under pressure and meet deadlines while managing multiple high priorities and supporting a flexible schedule
  • Knowledge and understanding of the Company's clients, products, departments, and workflows
  • Personal computer literacy and competency in use of Microsoft Word, Microsoft Excel (intermediate skill), Power Point and PowerBI
  • Ability to maintain a high level of objectivity and confidentiality
  • Experience in quality improvement activities within a healthcare, health insurance and/or managed care organization preferred
  • Experience in supplying small group and individual training preferred
  • Experience in research beneficial and preferred

Education:
  • High School Diploma
  • Preference for a bachelor's degree or equivalent experience

Work Environment:
Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).
Diversity Statement:
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Drug-Free Workplace:
This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. Employees are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.
California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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