Quality Management Specialist (Remote) 2025-1418

Sedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy | Sedgwick Terms and Conditions | Sedgwick

Are you passionate about ensuring quality and compliance in a dynamic environment? Join SGS as a Quality Control Analyst (QCA) and play a crucial role in supporting our Quality Management System (QMS) for a high-profile client. The Quality Management Specialist (QMS), you will work from your home office from Monday to Friday, 8AM - 5PM Eastern Time and be part of a collegial team that is responsible for supporting the Quality Management System (QMS) for a high-profile client. This role involves both clinical and non-clinical tasks to ensure compliance with QMS and client contracts. The QMS identifies requirements and creates processes to ensure consistent and reliable execution of work. They coordinate the creation of controlled documents such as Standard Operating Procedures and Work Instructions, perform audits to meet performance metrics, and address internal and client concerns. Additionally, the QMS tracks and mitigates risks, facilitates continual improvement by leading improvement projects, and supports contract managers and the analytics team in preparing quality assurance reports.

Provides input to SGS managers and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols. Assist with collection and summary of data in collaboration with SGS Quality Committees, identifies opportunities for improvement, and presents findings. Understands each contract's clinical quality assurance requirements and monitors compliance, in collaboration with the SGS analytics and management teams. Monitors and analyzes clinical outcomes in relation to goals and contractual requirements, in collaboration with the SGS analytics and management team. Performs standard and ad hoc audits of case management activities, as directed by quality committees. Provides feedback and coordination of improvement of quality tools, such as audit checklists and instructions. Assists in the identification of program deficits and coordinates team training and monitoring of corrective actions. Assists with performance improvement activities. Tracks client complaints and issues to resolution, in collaboration with the Account Managers. Identifies new areas that need quality monitoring, on a short-term or continuous basis. Assists in activities to prioritize improvement initiatives. Investigates and incorporates national best-practice interventions into SGS processes in conjunction with clinical management. Ensures that documentation produced and/or processed complies with federal regulations and contractual requirements. Assumes responsibility for related duties as required or assigned.