The Clinical QA Specialist is a registered nurse (RN) 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.
Education: Bachelor’s Degree required, and being Certified Professional in Healthcare Quality (CPHQ) preferred.
License(s): RN required
Relevant Work Experience: 5 years’ experience as an RN required, with at least 3 years in a Healthcare Quality role preferred. 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
- Competitive Salary starting at 75,000 CAD
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 history, yet we 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.
At Teladoc Health we thrive on difference and individuality. Teladoc Health is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
We are committed to fostering an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of our customers and communities in which we live and serve. If you require an accommodation for any stage of the recruitment process / interview process (including alternate formats of materials, or accessible meeting rooms or other accommodation), please reach out to us at firstname.lastname@example.org