Perform quality audits across all functions of utilization management operations, reviewing completed work in comparison to established documented procedures to determine accuracy. Handle BPO production and quality audits to ensure operations are effective, consistent and in compliance with business rules and CMS processing standards Comply to and reports all audit activity and results weekly to leadership team Provide monthly assessment and analysis of audit results Identify training opportunities based on quality assessment results Collaborate with Operations Managers to build and execute specific functional audit plans for claims, configuration, appeals and grievances and billing and enrollment functions Assist in the creation of departmental procedures and reference documents Review, evaluate, and make recommendations for process improvements