Quality Assurance Manager

6 days ago

Irvine, United States Providence Full time

**Description**

**_Providence caregivers are not simply valued - they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them._**

**Providence is calling a Quality Assurance Manager who will**:

- Be responsible for self-insured insurance program’s Medicare Secondary Payer Reporting requirements
- Ensure NPDB settlement reports are submitted timely and accurately
- Promptly and accurately submit regulatory reports to state governing agencies within Providence’s footprint
- Manage Payor Contracting Requests, including running data reports and providing appropriate loss information
- Timely and accurately report claims to excess carriers
- Complete Next of Kin searches
- Provide educational support to claims professionals
- Review, revise, and develop policies and procedures, as needed and upon request
- Run metrics reports
- Work collaboratively with fellow teammates
- Manage multiple time-sensitive priorities
- Work independently in a fast-paced environment
- Be adaptable

**_Providence is welcoming 100% remote work for residents who reside in the following States:_**
- Alaska
- Washington
- Oregon
- Montana
- Idaho
- California
- Nevada
- New Mexico
- Texas

**Required qualifications for this position include**:

- Bachelor's Degree in Management, Administration, Organization, Social Work Administration, or another related field of study **-OR-** a combination of equivalent education and experience
- 5+ years of experience in quality assurance working with liability claims and/or insurance

**Preferred qualifications for this position include**:

- Master's Degree in Management, Administration, or another related field of study
- Coursework/Training: Training in risk, claims, and insurance
- Applicable certifications in quality assurance or education
- 2+ years of experience developing policies and procedures and education for department in claims and/or insurance
- Civil Tort claims handling experience
- Risk Management Experience
- Experience working with Medicare Secondary Payor Reporting
- Experience handling Payor Contracting requests
- Experience with State and Federal settlement reporting
- Regulatory experience
- Experience working within a healthcare organization

**Salary Range by Location**:
**AK: Anchorage**:

- Min: $44.24
- Max: $70.03

**AK: Kodiak, Seward, Valdez**:

- Min: $46.11
- Max: $73.00

**Washington: Western**:

- Min: $46.11
- Max: $73.00

**Washington: Southwest - Olympia, Centralia & Below**:

- Min: $44.24
- Max: $70.03

**Washington: Tukwila**:

- Min: $46.11
- Max: $73.00

**Washington: Eastern**:

- Min: $39.36
- Max: $62.32

**Washington: South Eastern**:

- Min: $41.24
- Max: $65.29

**Idaho**:

- Min: $39.36
- Max: $62.32

**Oregon: Portland Metro Region**:

- Min: $44.24
- Max: $70.03

**Oregon: All cities outside of Portland**:

- Min: $41.24
- Max: $65.29

**California: Northern California**:

- Min: $51.74
- Max: $81.90

**California: Humboldt**:

- Min: $46.11
- Max: $73.00

**California: Southern California**:

- Min: $46.11
- Max: $73.00

**California: Bakersfield**:

- Min: $44.24
- Max: $70.03

**Montana: All cities outside of Great Falls**:

- Min: $35.62
- Max: $56.38

**Montana: Great Falls**:

- Min: $33.74
- Max: $53.42

**Nevada**:

- Min: $46.11
- Max: $73.00

**New Mexico**:

- Min: $35.62
- Max: $56.38

**Lubbock, Levelland, Plainview TX**:

- Min: $33.74
- Max: $53.42

**TX: Austin, Dallas, Houston, San Antonio**:

- Min: $44.24
- Max: $70.03

**Why Join Providence?**

**Our** **best-in-class benefits** **are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our** **Mission** **of caring for everyone, especially the most vulnerable in our communities.**

**About Providence**

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, ext

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