Job Description

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Drive measurable quality and operational improvements across Authorization Management by owning audit, issue-tracking, and process-improvement activities as a Senior Quality Analyst in Chennai, India. You’ll use healthcare operations expertise to support audit accuracy, identify root causes of recurring quality issues, strengthen reporting, and enable continuous improvement across authorization-related workflows. You will report to the Manager, Authorization Management Quality.

Team summary
The Authorization Management Quality team supports agents and operations colleagues who handle pre-certifications and referral work for providers. The team is accountable for quality oversight, audit support, issue resolution, cross-functional coordination, and continuous process improvement. You will contribute by leveraging operational analysis, quality insights, and athenahealth workflow knowledge to improve service delivery, strengthen accountability, and support scalable authorization management operations.

Essential Job Responsibilities

• Analyze authorization management quality data to identify trends, recurring issues, and opportunities for improvement.
• Own audit-related workflows for more complex cases, ensuring timely, accurate, and consistent completion.
• Review task notes, audit histories, and supporting documentation to determine appropriate next steps and corrective actions.
• Coordinate with internal stakeholders to resolve issues, reduce delays, and minimize rework across authorization-related workflows.
• Document case notes, actions taken, and outcomes in required systems to maintain traceability and audit readiness.
• Validate quality by ensuring work aligns to SOPs, operational standards, and established acceptance criteria.
• Identify root causes for recurring quality themes and propose practical process improvements.
• Report on key operational metrics, audit findings, and escalation themes to support goal tracking and performance management.
• Use AI-enabled assistance to improve speed and consistency by leveraging AI-supported summarization and anomaly detection where available, while applying judgment to verify accuracy and follow SOPs.
• Coordinate project plans and cross-functional initiatives related to department goals, process improvements, and workflow optimization.

Additional Job Responsibilities

• Support training and knowledge sharing by coaching peers on audit handling approaches and quality expectations.
• Contribute to process documentation updates and job aids based on observed operational learnings.
• Participate in quality calibration sessions to align on audit interpretation, documentation requirements, and escalation thresholds.
• Assist with implementation planning for process changes that affect authorization management workflows.
• Engage in continuous improvement projects aimed at improving accuracy, reducing cycle time, and supporting more efficient workflows.
• Participate in special investigations or deep dives for escalated quality or issue-tracking cases.
• Coordinate meetings, working groups, testing, product discussions, and process research as needed.
• Assist with identifying opportunities to reduce inflow through automation or process improvement.
• Serve as a mentor and escalation point for team members.
• Help create and update documents for projects and processes relevant to the team.

Expected Education & Experience

• Bachelor’s degree required; graduation in Nursing, Dentistry, Physiotherapy, or any health/life science preferred.
• 3–5 years of relevant professional experience in the healthcare industry.
• Experience in quality, audit, operations, or related analytical operational roles preferred.
• Proficiency in Microsoft Office Suite.
• Experience working with SOPs and quality standards to achieve consistent outcomes.
• Ability to analyze trends and translate findings into recommendations for process improvements.
• Strong communication skills to escalate, coordinate, and explain findings clearly to stakeholders.
• Comfort working in a hybrid environment based in Chennai, India