Clinical Specialist, Quality Management and Training

Job description

Overview Who We Are: Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives. Learn even more about the work that drives us at personifyhealth.com. The Clinical Compliance & Quality Specialist is responsible for ensuring regulatory and quality compliance across clinical operations. This role requires consistent use of independent judgment and discretion in evaluating, auditing, and improving clinical systems and processes. The specialist collaborates with internal teams and external regulatory bodies to uphold standards set by state, federal, and accreditation organizations Responsibilities: Ready To: What You'll Actually Do: - Ensure compliance with state, federal, and accreditation standards, including ERISA, NCQA, URAC, and HIPAA. - Conduct internal and external audits of clinical programs...