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Quality Assurance Associate II

3 months ago

Hamilton, United States Conduent State Healthcare, LLC Full time

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.


Quality Assurance Associate II

$21.00/Hourly

Full-time with Full Benefits

 

 

Working for you:  

 Enjoy a positive, employee-friendly culture while playing an important role in supporting our clients.

  • $21.00 per hour pay rate (bi-weekly pay)
  • Paid Training 
  • Full-time schedule 40 hrs. a week 
  • Career Growth Opportunities 
  • PerkSpot- Employee discount program 
  • Full Benefit Options - From the start, our paid training program will teach you all the skills needed to allow you to become successful in your role. We also offer a full benefits package, so youâll be able to thrive both personally and professionally.

Job Details:

 

Reporting directly to the Continuous Quality improvement (CQI) Supervisor, the CQI Specialist ensures elements of the Quality Assurance Plan are carried out and contractually required performance requirements are maintained. Perform quality assurance reviews on all components of the operations and conduct call monitoring, eligibility determination reviews, and other unit monitoring, based on the QA policies and procedures.

 

About the Role

 

  • Perform quality assurance reviews on all components of the operations under approved policies and procedures.
  • Monitor and assess functions to ensure contractual and quality performance standards are maintained in mailroom functions, inbound and outbound calls, data entry, correspondence processing, enrollment processing, eligibility processing and determination, premium processing, complaint/grievance processes, training activities, and HR procedures.
  • Maintain technical and program policy proficiency in the NJ Family Care program and maintain proficiency in contract requirements.
  • Monitor and assess individual/group performance against established standards/requirements.
  • Enter QA review results into the database for quality assurance scorecard reporting.
  • Identify, develop, and assist in the execution of corrective action measures as needed to maintain or re-gain compliance on time.
  • Provide feedback to the leadership team and assist in addressing education/training needs with the Project Director, Managers, and Supervisors including preparing summaries and presentations when appropriate.
  • Compile and analyze data to assist with contractually required, ad hoc, and internal management reports as needed.
  • Participate in and contribute to the quality improvement process.
  • Assist in collecting information for staff performance reviews by monitoring individual and group performance against established standards.
  • Provide feedback to leadership staff on areas for improvement.
  • Work with the management team to develop and execute corrective action plans in the event of contractual non-compliance.
  • Participate in training sessions.
  • Other duties as assigned. (Including operational assistance to other departments)

Requirements:

  • Must be 18 yrs. of age or older.
  • High School Diploma or GED
  • Background screening 

Preferred Experience: 

  • Associate degree preferred.
  • A minimum of two (2) years of experience providing corporate quality assurance is preferred.
  • Experience utilizing state-of-the-art technology and quality methods to implement improvements and change in an organization.
  • Experience in public sector administration, outsourcing/production environment, Medicaid, and/or CHIP a plus.
  • Outstanding oral and written communication skills, strong interpersonal skills, and superior organizational abilities.
  • Ability to take initiative, maintain confidentiality, to meet deadlines, and to work in a team environment.
  • Prioritize required tasks along with special project demands.
  • Extreme attention to detail
  • Thorough understanding of all areas of operations to evaluate quality in work processes.
  • Problem solves through analysis and ongoing feedback.
  • Develop correction action plans for areas not meeting performance standards through data analysis and trend identification.
  • Ability to champion change within a formal organization
  • Ability to handle multiple tasks and meet deadlines, flexibility under pressure.
  • Ability to work with people of diverse backgrounds.
  • Ability to maintain strict confidentiality.
  • Capable of working independently
  • Ability to use MS Word, MS Excel and MS Outlook required.
  • Bilingual is a plus.

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent's ADAAA Accommodation Policy.

At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.