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Progyny, Inc. · 6 hours ago

Clinical Experience & Audit Manager

Missouri, United States

Full-time

Onsite

Mid, Senior Level

$105K/yr - $125K/yr

5+ years exp

Progyny, Inc. is a global leader in women’s health and family building solutions, and they are seeking a Clinical Experience & Audit Manager to oversee and manage all clinical audit activities. This role involves ensuring compliance and quality in clinical programs, while serving as a liaison between Progyny and external partners.

FertilityHealth CareMedical

Comp. & Benefits

No H1B

Responsibilities

Serve as the primary point of contact for all external clinical audits conducted by consultants and health plan partners

Manage the full audit lifecycle — planning, data collection, coordination with internal stakeholders, response development, and corrective action follow-up

Develop and maintain standardized audit processes, documentation, and tracking systems to ensure efficiency, consistency, and compliance

Summarize audit findings, identify root causes, and work with cross-functional teams to implement sustainable improvements

Design and lead QA programs to regularly evaluate the accuracy, consistency, and quality of member experiences across all touchpoints (clinical, operational, digital)

Collaborate with the Member Experience, Operations, and Product teams to identify and close gaps between our intended and actual member journeys

Translate qualitative and quantitative insights into actionable improvements that enhance the clinical and emotional aspects of the member experience

Partner with Medical Economics to assess audit trends and translate findings into measurable business and clinical outcomes

Work with Product and Operations teams to ensure process enhancements and system changes align with clinical quality standards

Provide data-driven insights and recommendations to Clinical and Executive Leadership to inform strategic decision-making

Support regulatory, compliance, and accreditation efforts as needed

Qualification

Clinical audit managementQuality assurance frameworkHealthcare data analysisHealthcare quality frameworksProject managementCross-functional collaborationAttention to detailOrganizational abilities

Required

Bachelor's degree in Nursing, Health Administration, or a related clinical or healthcare field

5+ years of experience in clinical audit management, healthcare/consultant quality, or clinical operations — ideally within payer, fertility, or managed care settings

Proven experience managing external audits and implementing corrective action plans

Strong analytical skills and familiarity with healthcare data and quality metrics

Excellent project management and cross-functional collaboration skills

Exceptional attention to detail and organizational abilities

Preferred

Master's degree in a related field (e.g., MPH, MHA, MSN)

Experience in fertility, reproductive health, or women's health

Familiarity with healthcare quality frameworks (e.g., NCQA, URAC, CMS)

Understanding of member journey mapping and experience measurement methodologies

Benefits

Paid family and parental leave

Preconception, fertility and family building benefits (including egg freezing, IVF, and adoption support)

Family and pet care fund

Parents’ Employee Affiliation Group

Menopause and midlife care

Health, dental, vision and life insurance options for employees and family

Free in-person, virtual and text-based mental health and wellness support

Paid time off, including vacation, sick leave, personal days and summer flex time

Company equity

Bonus program

401(k) plan with company match

Access to on-demand legal and financial advice

Learning and development programs to help you grow professionally and a mentorship program

Company social events to include annual volunteer day and donation matching

Flex days (3 days a week in the office) and onsite meals and snacks for employees reporting into our NY office

Company

Progyny, Inc.

Glassdoor3.8

Progyny (Nasdaq: PGNY) is a transformative fertility, family building and women’s health benefits solution, trusted by the nation’s leading employers, health plans and benefit purchasers.

Founded in 2008

New York, New York, USA

501-1000 employees