EL Review Specialist

2 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.


 

EL Review Specialist  

Remote- Hamilton, NJ  

Pay Rate: $21/hr.   

Full-time with Full Benefits Shifts: Monday- Friday 8:00 am- 4:30 pm or 8:30 am- 5:00 pm  

  

Are you seeking an opportunity to make a real impact in a company that appreciates ideas and new ways of thinking?   

Join the Conduent Customer Service Team 

Come join us and grow with a team of people who will challenge and inspire you to be the best ⯠ 

Position Purpose: Reporting directly to the EL Review Supervisor, the EL Review Specialist ensures elements of the Quality Assurance Plan are carried out and contractually required performance requirements are maintained.⯠Perform quality assurance reviews on eligibility determination cases, based on the approved Quality Assurance (QA) Plan and QA policies and procedures.⯠  

 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)⯠ 

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.⯠

 

Essential Job Duties  

Review eligibility cases meeting all production and quality goals.  

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 in a timely manner  

Provide feedback to the leadership team and assist in addressing education/training needs with 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.⯠  

Conduct grievance and complaint investigation, documentation, and resolution activities in accordance with approved policies and procedures.  

Participate in training sessions.  

Support Eligibility with the processing of Cases  

Other duties as assigned.  

  

Minimum Experience Requirements  

Associates degree required. Relevant quality assurance experience can be substituted for education on a one-for-one basis.   

A minimum of two (2) years of experience providing corporate quality assurance.   

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.   

The ability to take initiative, to maintain confidentiality, to meet deadlines, and to work in a team environment is essential.   

  

Required Skills/Abilities   

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.   

  

 Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information.  For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The pay for this role is $21.00 per hour.   

  

 

 


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.

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