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Senior Manager Quality Audit Operations (Clinical Chart Vali

Cotiviti, Inc. • South Jordan, UT • 8h ago

Senior Manager Quality Audit Operations (Clinical Chart Validation)

Job Locations

US-Remote

2026-19864

Category

Audit - Healthcare

Position Type

Full-Time

Overview

The Senior Manager, Quality Assurance leads a team of quality-focused individuals across multiple review @types responsible for developing, executing, and continuously improving CCV's quality assurance programs, and ultimately, delivering value to our clients. This leader oversees the governance of quality standards, criteria, audit guidelines, and monitoring processes to ensure programs are evaluated, maintained, and refined over time. The Senior Manager is responsible for ensuring the accurate application of audit guidelines applied through AI-supported and human-reviewed processes, to support high audit accuracy, consistent and sustainable review outcomes, and reliable identification of quality opportunities. Grounded in Cotiviti's values-Deeply Curious, People Obsessed, Make it Count, and Build it Better-the Senior Manager fosters a culture of inquiry, accountability, collaboration, and continuous improvement. This role will also focus on incorporating innovation and AI into the QA program to make it more proactive and effective in identifying, prioritizing, and closing vulnerabilities. The role is expected to move beyond reporting results to proactively identify emerging risks, influence corrective action, and confirm measurable, sustained improvement across AI-supported and human-reviewed workflows. The Senior Manager serves as a business partner to operational leaders while fostering alignment among key stakeholders across CCV operations, concept development, machine learning and strategic analytics, and client service teams.

Responsibilities

AI-Enabled Quality Program Governance

Owns and matures the quality program framework, including quality controls, sampling strategy, escalation routines, governance cadence, and sustained monitoring.

Defines, measures, and monitors accuracy, consistency, and decision quality across AI-supported and human-reviewed workflows.

Identifies early quality signals, accuracy drift, and client-facing or operational exposure before issues escalate externally, using root cause analysis, trend monitoring, and risk segmentation to determine whether issues are isolated, systemic, or likely to affect our clients.

Partners consultatively with operations, analytics, technology, training, and client-facing leaders to translate quality findings into action.

Develops remediation plans that include containment, ownership, timelines, measurable success criteria, governance checkpoints, and evidence of sustained improvement.

Ensures changes to AI-supported workflows are supported by controlled pilots, release-readiness criteria, risk-based testing, documentation, post-implementation monitoring, and stakeholder alignment.

Champions innovation and responsible use of AI to creatively improve audit performance, increase review effectiveness, strengthen quality insights, and identify scalable opportunities to improve accuracy, productivity, risk detection, and client value.

Drives continuous improvement by establishing clear accountability, ensuring disciplined execution of quality actions, and positively influencing auditor and audit behavior through data-driven coaching, feedback loops, reinforcement of expectations, and sustained monitoring of outcomes. Communicates emerging risks and remediation progress clearly to senior leadership with appropriate urgency, balance, and action orientation.

Relationship Management

Maintains professional r

elationships across the quality organization and audit enterprise. Identifies opportunities to expand the scope of quality... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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