Open Alerts
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Active compliance issues
Critical Alerts
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Require immediate action
Avg QA Score
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Overall case quality
QA Reviews
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Cases reviewed this period
Audit Actions
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Logged today
SMART Compliance
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Cases ≥80% threshold
Active Compliance Alerts
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Resolved Alerts
Submit QA Review
Accuracy ×35%
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Complete ×25%
—
Compliance ×25%
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Timeliness ×15%
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Overall
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Recent QA Reviews 0
| Case | Auditor | Overall | Status | Date |
|---|---|---|---|---|
Total Actions
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Active Staff
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Actions Today
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Doc Access
—
| Timestamp | Employee | Action | Entity | Details | IP Address |
|---|---|---|---|---|---|
Staff Performance Leaderboard
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Team Performance Heatmap
| Staff Member | Total Cases | Approval Rate | Avg Turnaround | Avg SMART | QA Score | Cases/Week | Composite |
|---|
P2P Success Rate
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Peer-to-peer approvals
Rework %
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Cases requiring re-review
Appeal Success
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Overturned denials
Authorization Turnaround Trend (8 weeks)
First-Pass Approval Rate by Reviewer
Denial % by Root Cause
SMART Score Compliance by Reviewer
Role-Based Access Control Matrix
| Module | Intake | Admin | LPN | RN | P2P | QA | Supervisor | Executive |
|---|
Legend:
✔ Full access · View Read-only · — No access · Supervisor always has escalation override