Livongo Clinical QA Specialist - Healthcare (remote role) in Montréal, United States
(This is a 100% remote position - the full flexibility to work from home!)
As the world leader in virtual care, Teladoc Health is passionate about taking care of people. We have been providing care in Canada for over two decades to more than 9 million Canadians and 85,000 plan sponsors. We deliver care across 175 countries (over 51 million members globally), living our mission to empower all people to live their healthiest lives by transforming the healthcare experience. Levering digital technology, we provide whole-person care that spans every stage in a person’s health journey from wellness and prevention to acute care to complex healthcare needs. Our Canadian team has doubled in size over the last two years, and our growth is expected to rapidly continue as we transcend the landscape of future healthcare.
The Clinical QA Specialist is a position that focuses on supporting Teladoc’s robust quality assurance (QA) program. Functions include: review, research and report all member complaints and inquiries, sample and review provider consults for documentation standards and clinical appropriateness, and review members with a frequent utilization of the program. It may also involve the development and updating of evidenced based clinical guidelines and support for quality and credentialing committees.
Serve as company liaison with external accreditation organizations such as URAC, NCQA, Accreditation Canada; understand current accreditation standing of Teladoc.
Lead accreditation initiatives from initiation through awarding of accreditation status.
Serves as lead RN in collaboration with medical director on quality care, complaints, quality improvement and patient safety initiatives for health plans and key accounts.
Work closely with the Clinical Quality team to ensure internal stakeholders understand applicable standards, policies and procedures, and efforts needed to maintain compliance with current accreditations and to apply for new accreditation status.
Serve as internal liaison to identify, track, and meet deliverables, escalate any issues or barriers that remain unresolved by the team, and manage all work-streams to meet deliverables and deadlines.
Serve as primary nurse contact for quality concerns, questions, and improvement initiatives for large health plan clients and key accounts. Responds to various client and account inquiries related to the provider and clinical quality areas.
Lead the incident management and reporting process for the organization.
Lead organization wide initiatives for quality improvement using tested methodologies.
Coordinate and lead Performance Improvement projects as identified by the CMO
Collaborate with credentialing professionals in provider performance evaluation.
Generates departmental performance statistics. Monitor, track, and trend through incident reporting and facilitate appropriate provider reviews.
Perform other duties as assigned.
Bachelor’s Degree preferred, and being Certified Professional in Healthcare Quality (CPHQ) preferred
+3 years’ experience in a Healthcare Quality role required (Registered Nurse RN preferred but very open to other healthcare professionals)
Experience in quality accreditation through organizations such as URAC, NCQA or similar strongly preferred
Patient Safety and Risk Management experience preferred
Previous FPPE/OPPE, or provider evaluation development a plus
Bilingual (English / French) preferred.
Knowledge in obtaining quality accreditation through organizations such as URAC, NCQA or others
Ability to set up project teams, work streams and executive steering committees
Experience with project management tools, spreadsheets, tracking deliverables and issues, meeting deadlines
Excellent written and verbal communication, and presentation skills
Ability to manage multiple projects simultaneously
Familiar with drafting and implementing policies and procedures
Attention to detail
Ability to understand health data and prepare reports
Positively collaborates with other employees and departments to complete objectives
Comfort with change, uncertainty, and proceeding without a previous roadmap
Comfortable working independently and communicating through multiple levels in the organization
Why Join Teladoc Health?
A New Category in Healthcare : Teladoc Health is transforming the healthcare experience and empowering people everywhere to live healthier lives.
Our Work Truly Matters: Recognized as the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person’s health journey.
Make an Impact: In more than 175 countries and ranked Best in KLAS for Virtual Care Platforms in 2020, Teladoc Health leverages more than a decade of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals.
Focus on PEOPLE : Teladoc Health has been recognized as a top employer by numerous media and professional organizations. Talented, passionate individuals make the difference, in this fast-moving, collaborative, and inspiring environment.
Diversity and Inclusion : At Teladoc Health we believe that personal and professional diversity is the key to innovation. We hire based solely on your strengths and qualifications, and the way in which those strengths can directly contribute to your success in your new position.
Growth and Innovation : We’ve already made healthcare yet remain on the threshold of very big things. Come grow with us and support our mission to make a tangible difference in the lives of our Members.
As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status or pregnancy (including breastfeeding – we have a mother’s room in both our offices). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.