Senior Clinical Intelligence Quality Specialist

Job not on LinkedIn

🔥 3 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

👻 Ghost score 10%

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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

• Lead complex clinical audits, validation reviews, performance investigations, and reviewer-calibration activities • Audit clinical recommendations, summaries, assessments, indicators, classifications, document outputs, and level-of-care results using approved methodology • Assess accuracy, completeness, clinical support, contextual appropriateness, workflow suitability, and potential patient-safety concerns • Document error type, severity, likely source, downstream impact, and required escalation • Meet throughput, quality, documentation, and turnaround expectations while preserving clinical rigor • Support pre-launch validation, regression testing, post-launch surveillance, targeted review, and revalidation after material changes • Investigate disagreement patterns, clinician feedback, performance drift, data-quality concerns, and recurring error themes • Evaluate performance variation across clinical populations, care settings, client workflows, and relevant subgroups • Recommend enhanced surveillance, remediation, or escalation when evidence indicates increased clinical risk • Participate in clinical reviewer calibration and perform secondary reviews or quality checks • Convert findings into structured data for dashboards, trend reporting, root-cause analysis, and governance decisions • Summarize clinically meaningful findings for Product, Data Science, Clinical Programs, Compliance, and executive audiences • Partner with Data Science and Product on findings and remediation without owning technical model changes • Partner with Clinical Programs regarding adoption, workflow, and education barriers • Escalate potential patient-safety concerns and unsupported adverse outputs through defined channels • Contribute to improving audit tools, definitions, reviewer guidance, and evidence standards • Travel occasionally by air or car to client sites, industry meetings, and team gatherings

🎯 Requirements

• Bachelor’s degree in nursing, occupational therapy, physical therapy, or another relevant clinical discipline • Active and unrestricted clinical license • Registered nurse preferred based on the breadth of the current portfolio • Five or more years of clinical experience, including at least three years in post-acute care, Medicare Advantage, utilization management, clinical quality, documentation review, or related work • Strong medical-record review skills and ability to evaluate clinical evidence, criteria, documentation quality, and decision support • Experience reviewing longitudinal medical records and synthesizing information across multiple clinical document types and care settings • Experience auditing clinical decisions, documentation, abstraction, criteria application, utilization management, or quality outcomes • Ability to distinguish material clinical errors from minor documentation variance and explain potential downstream impact • Ability to interpret clinical performance measures such as agreement, sensitivity, specificity, precision, false-positive and false-negative patterns, error severity, and subgroup performance • Strong written findings, analytical reasoning, organization, and comfort working with structured data and evolving protocols • Must be authorized to work in the United States without visa sponsorship at the time of application and throughout employment

🏖️ Benefits

• Annual performance bonus • Equity participation for eligible roles • Comprehensive medical, dental, and vision coverage • 401(k) with employer match • Company-paid life and disability coverage • Mental health and family support benefits • Remote-first work within the United States • Flexible time off • Paid holidays • Paid parental leave • Tuition and certification assistance for role-relevant credentials • Occasional travel for team offsites and client engagements • Direct access to clinical, product, and executive leadership • Reasonable accommodations throughout the application and employment process