Clinical Intelligence Quality Auditor – Contract

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $55 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Post Acute Analytics

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

🏥 Healthcare

☁️ SaaS

🤝 B2B

💰 Venture Round - Post Acute Analytics on 2025-09

Healthcare • SaaS • B2B

Post Acute Analytics is a healthcare-focused technology company that provides a cloud-based post-acute care management platform (Continuum of Care Suite™) and clinical consulting to give health systems total transparency into patients’ journeys after acute care. Their platform, powered by "Anna™", offers automated data capture from structured and unstructured sources, real-time connections to acute and post-acute EMRs, predictive analytics to identify high-risk patients, patient tracking and “off-track” alerts, and automated care-pathway creation to support utilization and care management. PAA targets value-based and risk-based contracts (bundles, ACOs, Medicare Advantage) and positions its solutions to reduce readmissions, lower total cost of care, and improve in-network utilization, delivered as a SaaS/cloud solution with integrations and partner programs.

📋 Description

• Complete assigned clinical audits according to approved sampling, methodology, documentation, quality, and turnaround requirements • Evaluate clinical indicators, document classifications, summaries, assessments, recommendations, and other assigned clinical intelligence outputs • Assess whether outputs are accurate, complete, clinically supported, appropriately contextualized, and suitable for the intended workflow • Identify missing, conflicting, outdated, or unsupported information and escalate potential safety concerns • Document findings using approved audit definitions, error taxonomy, and severity classifications • Escalate potential patient-safety concerns, unsupported adverse outputs, recurring error patterns, and unclear standards • Support temporary increases in audit or surveillance activity for launches, remediation, client concerns, performance changes, or solution updates • Participate in clinical reviewer calibration and incorporate feedback • Maintain confidentiality, reliability, and timely communication • Communicate workload constraints, case complexity, and potential delays for capacity planning • Apply approved audit methodology consistently across assigned solutions and clinical domains • Maintain traceable documentation for quality review, trend reporting, and governance decisions • Distinguish clinical intelligence performance issues from documentation, workflow, education, and data-availability concerns • Participate in secondary review or quality checks when requested • Contribute observations to improve audit definitions, reviewer guidance, or escalation processes • Execute objective clinical findings while governance leadership retains responsibility for methodology, risk thresholds, and portfolio-level decisions • Escalate cases requiring additional clinical or governance judgment rather than making independent launch, pause, or remediation decisions • Partner with clinical quality specialists and reviewers to maintain consistent interpretation of audit definitions and severity classifications • Provide findings supporting Product, Data Science, and Clinical Programs • Maintain objectivity and document favorable and unfavorable findings consistently

🎯 Requirements

• Active and unrestricted clinical license as a registered nurse, occupational therapist, physical therapist, or another discipline relevant to assigned clinical reviews • Registered nurse preferred based on the breadth of the current portfolio • Three or more years of experience in post-acute care, utilization management, care management, clinical documentation review, clinical quality, or a related healthcare environment • Strong medical-record review skills and post-acute clinical judgment • Ability to apply structured audit guidance consistently • Experience reviewing longitudinal medical records and synthesizing information across multiple clinical document types or care settings • Ability to distinguish material clinical concerns from minor documentation variation and explain potential downstream impact • Ability to work independently, meet deadlines, document concise findings, and escalate uncertainty or concerns appropriately • Availability for approximately 20 hours per week during the initial six-month engagement • Preferred: experience with skilled nursing, home health, care transitions, prior authorization, continued stay, or level-of-care review • Preferred: health plan, delegated utilization-management, clinical-criteria, or authorization-review experience • Preferred: experience with clinical abstraction, informatics, clinical decision-support validation, healthcare quality assurance, or performance monitoring • Preferred: experience evaluating clinical intelligence, AI-enabled healthcare tools, NLP-generated content, predictive analytics, or other technology-supported clinical outputs • Preferred: experience working with healthcare technology, Product, Data Science, or clinical informatics teams • Preferred: familiarity with agreement, sensitivity, specificity, false-positive and false-negative patterns, and error severity

🏖️ Benefits

• Flexible clinical review capacity within a contract engagement • Initial six-month contract engagement • Approximately 20 hours per week • Potential contract extension or expansion based on business needs, workload, and performance • Potential consideration for future full-time opportunities (conversion not guaranteed) • Reasonable accommodations during the selection and engagement process