Job description

Title: Remote - Operations Quality Analyst

Address: Newtown Square, PA 19073

Duration: 03+ Months with a strong possibility of extension

Shift: 8:30am–3:29pm (Mon-Fri)

Duties:

The primary purpose of the Operations Quality Analyst is to provide high level technical expertise and analysis to the Community Health Choices Service Coordination department. They will work closely with configuration, PDM and the Plans to identify root cause and drive to resolution.

• Function as a key subject matter expert for all Community Health Choices Service Coordination activities.

• Have experience in auditing and quality review specific to service coordination activities.

• Maintain a current working knowledge of contractual guidelines, Plan policy and operational procedures to effectively provide subject matter expertise.

• Support the Community Health Choices Service Coordination team in identifying issues for quick remediation.

• Assist in analysis of target audits as required.

• Ability to communicate and represent the Community Health Choices Service Coordination team to the Enterprise, the health plan and outside auditors.

• Utilize various technology applications related to quality review data collection and analysis. (Excel/Access/Word)

• Identify audit trends and provide recommendations.

• Train any new QA staff

Skills:

• Extensive claim experience

• Strong understanding of facets applications

• Critical thinking skills

• Technically proficient

• Proficient in MS Excel and Word

Keywords:

Education: Bachelor's Degree or equivalent experience Skills and Experience:

Required Skills:

Collection

Data collection

Operations

Qa

Audit

Additional skills:

Excel

Facets

Pdm

Remediation

Subject matter expert

Auditing

Job Types: Full-time, Contract

Pay: Up to $32.92 per hour

Schedule:

• 8 hour shift

Education:

• Bachelor's (Required)

Experience:

• Data collection, Audit and Operations: 1 year (Required)
• claim: 1 year (Required)
• facets applications: 1 year (Preferred)

Work Location: Remote

gatheringourvoice.org is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, gatheringourvoice.org provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, gatheringourvoice.org is the ideal place to find your next job.