Provider Network Quality Assurance Specialist

From the original posting

US Accountabilities Develop and maintain a structured audit schedule for provider network operations, ensuring reviews are completed consistently and documented appropriately. Conduct research, analyze operational data, and recommend improvements to address administrative, organizational, and process-related issues. Maintain complete audit evidence and records to support internal reviews, external audits, regulatory assessments, and accreditation requirements. Evaluate provider directory accuracy and document review findings and follow-up activities in accordance with applicable DHB and NCQA…