Quality Auditor

Position: Quality Auditor

Job ID: 163451

Location: US-TX-Houston


Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

Texas Children’s Hospital Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 14,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.  At Texas Children’s Hospital, diversity, equity, and inclusion are at the core of our values and mission for all of our patients and families that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.



We are searching for a Quality Auditor and Tester within business operations, someone who works well in a fast-paced setting. In this position, you will use technical skills, expertise, and application knowledge to support developers, testers, and production teams. The Quality Auditor will perform or participate in various types of testing and post-implementation reviews as determined by the project. Members of this role understand how to create and execute functional testing so that they can support and enable key business processes.

A Quality Auditor in this role is expected to have experience with technical competencies such as SQL, TFS, UFT, VB, and Tapestry.


To excel in this role one must be able to break down raw information and undefined problems into specific workable components that in turn clearly identify the issues at hand. You also be able to understand health plan operations to analyze and propose technical strategies for the business. The Quality Auditor will also actively apply quality assurance, testing concepts, and methodologies.


Think you’ve got what it takes? 

Responsibilities :

  • Design and execute QA tests for System Updates, Databases and Software Applications, Eliglibty and Enrollment, Provider Setup, Benefits Coding, Contracts, Fee schedules, and Claim Editing Rules.
    Identify bugs and quality issues in development, service, or business processes.
  • Business Requirements: Works with project team and peers to understand customer needs.
  • Develop & Implement: Collaborate with managers for eligibility, provider setup, and medical policy/configuration to develop an audit program to review and evaluate the quality, accuracy, and timeliness of system updates.
  • Production Support: Helps to troubleshoot defects and or enhancements to systems and software. Tracks performance and production issues. Escalates production issues as appropriate.
  • Quality Assurance: Clearly and concisely report audit findings on a frequent basis to managers and assist with identifying performance and training gaps for the team. Ensure errors are identified and corrected quickly.
  • Quality Metrics: Develop and track quality metrics for the department and report to leadership on a regular basis. 
  • Process Improvement and Reporting: Identify and report the process improvement opportunities for the department to increase efficiencies, performance, and quality. Assist with the production of various reports regarding the department’s quality and performance.
  • Process, Policies, and Standards: Develop and maintain policies and procedures for the departmental audit program. 
  • Customer service: Works with QA manager to keep customers informed about any quality issues. Tracks and reports on issues and enhancement requests for the business in a timely manner.
  • Research/ Evaluation: Analyzes and tests new releases/versions of software. May participate in vendor evaluations.


Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption

·       High school diploma or GED 

·       Bachelor’s degree in health care administration, business administration, computer science, or related field preferred 

·       2 years’ experience in Medicaid managed care 

·       4 years’ experience in health plan operations, and 4 years’ experience in health plan payor systems/applications 

·       2 years’ experience in auditing/quality review/training preferred 

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