Quality Systems Consultant

Responsible for promoting quality throughout the company, implementing and leveraging the Quality Management Systems (QMS) at all levels of the organization. Evaluates strategies, policies, processes and procedures as part of the management system. Promotes a Quality Culture, supports initiatives that drive on-going process improvement, facilitating changes to the quality strategy into the business.


  • Implement and design portions of quality performance indicators, tools and processes for data

collection, analysis and reporting for quality management

  • Perform analysis and reviews of performance standards and contract requirements and report

quality performance

  • Perform payment file reviews
  • Audit, consolidate, and analyze multiple streams of quality data and process results to identify

trends and issues, perform root-cause analysis, develop recommendations for resolution, and

track effectiveness of remedies

  • Communicate product and process issue analysis to stakeholders; implement product or process

changes to improve quality and minimize risk

  • Identify and conduct process improvement and quality-oriented studies, projects, and audits of

organizational processes

  • Collaborate with operational, technical and account subject matter experts and leaders
  • Participate in and attend System Development Notices (SDNs), Problem Statement resolution,

and Erroneous Payment Correction (EPC) meetings and confirm follow-up and resolution

  • Contribute to implementing, sustaining, promoting, and operation of QMS structure, processes,

policies, and procedures for the organization

  • Update and perform reviews for quality-related plan, manual and reports

Education and Experience:

  • Bachelor’s degree in insurance, healthcare, or related field; may hold two-year post-high school


  • Current certification and licensing in area of expertise


  • Three to five years of experience in a training development role
  • Two to four years of experience managing moderate to large projects
  • Strong facilitation, content design, and consulting skills
  • Strong leadership, communication, change management, and relationship

management skills

  • Ability to quickly understand new, complex tools, technologies, and systems
  • Good working knowledge of project management, research, and problem-

resolution techniques

  • Strong written and oral skills

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