Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests. Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: Subsidized, personal healthcare coverage (medical, dental vision) Professional Development, CEU, and Tuition Reimbursement Curated Wellness Benefits supporting teammates physical and mental well-being Community engagement opportunities And more! The Quality Auditor effectively and efficiently manages a diverse workload in a fast- paced, rapidly growing environment. The Quality Auditor KRS provides support to the local market teams but reports centrally to the Director of Audit and Risk. This individual will monitor the effectiveness and outcomes of the Quality program in the division, local market population health interventions, member experience, as well as the quality of service provided to Somatus by any vendors. The Quality Auditor KRS is also responsible for identifying and applying appropriate metrics for CKD and ESKD patients, evaluating the data, reporting results to various audiences, and designing and implementing process improvement projects as needed. This individual collaborates with multiple leaders at various levels throughout Somatus, including directors and vice presidents, for the purpose of supporting and improving the Quality program and all quality efforts. Responsibilities Uphold and support the mission, values, and policies of Somatus and KRS Assist Directors of Quality on quality and utilization audits as assigned, including targeted audits as requested by the Director. Analyze and interpret data to makes recommendations to optimize Population Health and kidney care specific outcomes that support Somatus corporate goals (including but not limited to peritoneal dialysis rates, central venous catheter utilization rates, kidney transplant rates) Monitor for potential compliance risks, including documentation discrepancies, missed care interventions, or other variances. Conduct comprehensive audits of clinical documentation within various EMR systems to ensure accuracy, completeness, and compliance with established guidelines. Identify trends and opportunities for quality improvement in clinical documentation and care management practices. Provide consultation and advice to Population Health leadership and Corporate leadership related to policies and procedures identified as out of date or incomplete and investigate, develop, and recommend process improvements and solutions. Monitor and analyze processes and outcomes to ensure Somatus goals, objectives, accreditation, and regulatory requirements are met. Assess care delivery for compliance with evidence-based practices, focusing on chronic care management, CKD, and ESKD protocols. Support quality improvement team in the development of reporting to prioritize clinical and service improvement initiatives and address identified barriers. Actively participate in new employee orientation, ongoing educational and compliance programs, staff meetings, continuous quality improvement, and periodic performance/protocol evaluations and development Assist with telephone audits via assigned telephonic and computer equipment. Maintain current licensure by completing applications for renewal in a timely manner and by complying with all requirements for continuing education. Travel (up to 25%) to local renal care providers for quality oversight and utilization review collection Other duties as assigned. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Qualifications Required Graduate of an accredited School of Nursing with BS/BA in Nursing or BA/MSW in Social Work. Is proficient in data analysis and EMR navigation, hands on experience with Renal ICUE require. Prior clinical experience in dialysis or renal care setting is a must. Current state licensure and other states as deemed necessary by state law or client contract. Minimum of three years recent clinical experience in a data-driven, quality focused role with a health plan, hospital, dialysis center, or large physician practice Strong Microsoft Word, Excel, PowerPoint skills to effectively communicate data and reports to internal and external stakeholders concisely and clearly. Prior experience with analyzing, interpreting, and presenting data sets. Preferred Certification in healthcare quality, such as Certified Professional in Healthcare Quality (CPHQ) or similar. Prior experience auditing calls and correlating to clinical documentation. Prior experience in population health, implementing market strategies, analyzing interventions and outcomes, and quality indicator data. Experience with data to inform clinical intervention processes, resource management, and strategic decision making. Experience with using or advising on data use for dashboard development, clinical best practices, and workflows. Knowledge of industry regulatory standards and accrediting bodies for population health, healthcare quality assurance, and care management Knowledge, Skills, & Abilities An ability to establish and maintain effective working relationships with coworkers using emotional intelligence, problem solving skills, and conflict resolution skills. Strong ability to communicate effectively both verbally and in writing; thoughts are logical and clearly expressed. Analytical thinking and problem-solving. Excellent organizational abilities and ability to prioritize tasks. Commitment to continuous learning and improvement in quality standards. Must be a self-starter to meet projects deadlines, achieve performance standards, and maintain professionalism in the virtual work environment. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.