[Hiring] Quality Operations Specialist @Carrum Health

Role Description

The Quality Operations Specialist I, Flex is a vital member of the Operations team, supporting accurate documentation, consistent workflows, and a high-quality patient experience. In this role, you will complete daily quality activities, including:

• Auditing the care team and operational documentation and workflows against established standards.
• Documenting findings and escalating concerns for review.

This is an entry-level role, typically requiring 1–2 years of relevant experience, where you will follow defined audit criteria, standard practices, and documented procedures. You will receive training and guidance as you learn our quality standards and internal systems. Success requires strong computer skills, sound judgment, attention to detail, and confidence identifying when information is incomplete or a process does not meet expectations.

You’re excited about this opportunity because you will:

• Execute Daily Quality Audits: Review documentation and workflows for accuracy, completeness, timeliness, and adherence to established quality standards and procedures.
• Apply Consistent Audit Standards: Use approved audit tools, checklists, and scoring criteria to evaluate work objectively. Participate in calibration sessions to build consistency across reviewers.
• Document and Escalate Findings: Record clear, factual audit results and flag documentation gaps, workflow deviations, and potential patient-impacting concerns through established escalation channels.
• Track Quality Follow-Up: Maintain audit records and follow-up trackers, and complete assigned rechecks to confirm that identified issues have been addressed.
• Identify Patterns and Improvement Opportunities: Recognize recurring errors and process gaps, and share observations that help the team improve documentation, workflows, and training.
• Support Quality Reporting: Accurately enter, organize, and validate audit data to support routine reporting and visibility into quality trends.
• Support AI Auditing Capabilities: Learn approved AI-enabled quality tools, compare AI-generated findings with source documentation and audit criteria, and flag inaccurate, incomplete, or unsupported results.
• Test and Improve Tools: Participate in testing updated audit tools and workflows, providing practical feedback on accuracy, usability, and efficiency.
• Protect Patient Information: Handle sensitive information with discretion and follow organizational privacy, security, and HIPAA policies.
• Master the Data: Support reporting and information management by collecting and cleaning data, ensuring the Care and Operations teams have accurate insights to drive decisions.
• Be a Voice for Improvement: Contribute fresh ideas and insights that lead to more efficient internal systems and better outcomes for our patients.

Qualifications

• Typically have at least 1–2 years of relevant experience in quality assurance, auditing, healthcare operations, documentation review, or a related field.
• Communicate findings clearly and respectfully, ask clarifying questions, and seek guidance when a situation falls outside established criteria.
• Demonstrate strong attention to detail and can compare documentation and completed work against defined requirements.
• Have foundational auditing skills or transferable experience reviewing records, identifying discrepancies, and documenting findings objectively.
• Treat every patient and teammate with patience, kindness, and respect.
• Stay positive when things change and are comfortable improving live processes while maintaining a high level of discretion with confidential information.
• Committed to following documented policies and adhering strictly to HIPAA requirements.
• Have a basic understanding of AI-enabled tools and are comfortable building the skills needed to work in an AI-assisted auditing environment.

Benefits

• Stock option plan and performance bonus for eligible employees.
• Flexible schedules and remote work.
• Chicago and San Francisco offices available as an option.
• Flexible PTO, within reason.
• Summer Fridays (sign off @ 1pm local time).
• 15+ paid holidays, including Juneteenth, World Mental Health Day, and Carrum Health Day.
• Annual holiday shutdown in December.
• Paid parental leave.
• Health, vision, and dental insurance.
• Employee Assistance Programs (EAP).
• 401K retirement plan.

Company Description

Carrum Health’s mission is to change how we pay for and deliver specialty care. We offer self-insured employers and plan sponsors a value-based specialty care platform that connects their members with a rigorously vetted network of specialty care providers. Carrum’s transparent, all-inclusive bundled pricing, award-winning technology, and dedicated care navigation team help lower costs for both members and employers while delivering a superior member experience.

Since launching in 2014, we’ve partnered with top-quality providers across the nation including Cleveland Clinic, Johns Hopkins, Mayo Clinic, Stanford Health Care, and a growing network of 1,400+ COEs. We serve hundreds of self-insured employers including Fortune 50 companies, such as United Airlines, US Foods, and Prudential, and public sector clients such as the States of Maine, Nevada, Tennessee, and Self-Insured Schools of California.

The impact of our platform has been validated by a landmark RAND Corporation study, honored with prestigious awards from institutions like Harvard Business School & Harvard Medical School, and featured as a Harvard Business School case study.

As a recognized digital health leader, Carrum is frequently covered by national media, including Bloomberg, Fast Company, Fierce Healthcare, Fortune, Los Angeles Times, Reuters, TechCrunch, and U.S News & World Report. Backed by $96M from top-tier investors including OMERS, Tiger Global Management, Revelation Partners and Wildcat Ventures, we’re only scratching the surface of our opportunity. Come join us.