Medical Claims Quality Assurance Manager

Sectors:
Medical devices, Pharmaceuticals, Health, Social work
Locations:
International
Qualifications:
Not specified
Contract type:
Permanent
Hours:
Full time
Salary description:
Competitive
Specialist areas:
Quality assurance (main), Audit/assessment, Consultancy, Health and safety, Operational improvement, Project management, Risk management
Sub-sectors:
All
Posted:
01/08/2020
Start Date:
ASAP
Recruiter:
Conduent
Job Ref:
920493481

The Quality Assurance Manager is responsible for auditing internal and external processes, communications and policies on behalf of an organization. Maintains a positive relationship with the client, understanding expectations and needs, outlining quality standards and developing quality control processes. He/She works directly with the client concerning changes in reporting processes. Identifies potential risk and issues, minimizes and manages vulnerabilities and develops contingency plans. Assist in the overall goals of the account and company. Manages quality, project management and training staff to ensure adherence to contract requirements and SLAs

*Position is located in Ridgeland* (telecommuting during the Covid-19 environment)

MAJOR POSITION RESPONSIBILITIES:

Assure compliance with contractual standards, Company policy, State and Federal laws and regulations maintaining and monitoring staffing levels
Stay abreacted of changes in internal and Medicaid policies and procedures.
Analyze data and recommend changes to production processes or quality controls to eliminate or mitigate problems
Responsible for overall management of the quality, PMO and training.
Participates in strategy and long-range goals and objectives at the account level
Identifies potential risk and issues, minimizes and manages vulnerabilities and develops contingency plans
Formulates and implements procedures; ensures effective achievement of objectives within assigned departments.
Improve operational efficiencies and customer service through implementation of best practices
Provides data and feedback on activities, cost, operations, and forecast date to determine business progress
Work directly with the client concerning changes in program policy, processes or problem resolution
Provides regular updates to senior management regarding client issues.
Analyzes workflow and assignments to ensure efficient and cost-effective operations;
All other duties as assigned

Requirements:

A bachelor's degree with at least three (3) courses in statistics and/or quality assurance

a minimum of three (3) years progressive experience in the quality assurance function of a large scale claims processing organization or have at least five (5) years progressive experience in the quality assurance function of a large scale claims processing organization.

Closing Date:
29/08/2020
Contact Details:
Conduent
Contact: Click apply

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