Quality Assurance Reviewer

Grapefruit Health is a healthcare services company on a mission to solve the growing staffing shortage in healthcare by putting tomorrow's clinicians to work today. We train and manage clinical students to conduct remote, telephonic patient interactions using our purpose-built software. The result: patients receive timely support, healthcare organizations extend their capacity, and you gain real clinical experience before you graduate.

The role

As a GFH Quality Assurance Reviewer you will:

• Complete monthly claim review using clinical judgment and established policies and procedures by deadlines as assigned

• Support the network through systematic and consistent feedback and coaching regarding clinical appropriateness of interventions

• Identify quality improvement opportunities through ongoing evaluation of the efficiency and effectiveness of the quality assurance program

• Other duties as assigned

Responsibilities:

• Complete quality assurance review for the calls assigned to you

• Conduct structured telephonic assessments and wellness check-ins using The Grove (Grapefruit Health’s platform)

• Document interaction outcomes accurately within the platform

• Escalate patient safety concerns to the Vice President of Clinical Services

• Maintain strict HIPAA compliance and patient confidentiality at all times

• Participate in onboarding training and ongoing check-ins

Knowledge and Requirements

• Ability to meet multiple deadlines

• Strong written and verbal communication skills

• Strong quantitative, qualitative, and analytical skills including technical proficiency

• Must be able to work autonomously (with minimal direction) while also being part of an integrated team

Education and Experience Requirements

• Healthcare background

• Confidence and fluency in patient communication

• Familiarity with a real clinical software used in professional settings

• The satisfaction of genuinely improving patient outcomes

• Must be able to work up to 20 hours per week

• Strong related clinical knowledge

WHAT WE'RE LOOKING FOR

• U.S. based required

• Must have a healthcare background: nursing, pharmacy, social work, medical assisting, dietitians, CNA, pharmacy or similar

• Must have a compatible computer and cell phone with SMS

• Must be able to work at least 20 hours/week

• A quiet, private workspace free of background noise or distractions

• Strong verbal communication skills, or a genuine desire to develop them

• Comfort working independently in a remote environment

• Reliable availability for a minimum of 10 hours per week

Grapefruit Health is an equal opportunity employer. Students work directly for Grapefruit Health––we are not a third-party recruiter. All patient data is handled in accordance with HIPAA.