QA Analyst I

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our clients needs and tailoring innovative healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine

JOB SUMMARY:

This position administers routine daily and weekly audits of work performed in various operational areas to ensure continual adherence to defined business processes and procedures. The driven, results-oriented incumbent will work to identify defects, issues and/or trends present in new and existing processes while working to identify "root cause" of all defects incurred.

JOB ROLES AND RESPONSIBILITIES:

1. Administer assigned daily and weekly audits in a consistent and timely manner while ensuring continual compliance with department policies.
2. Ensure consistent identification of known defects within each process subject to audit. Effectively communicate defects in a manner consistent with departmental procedures. Escalate critical issues to senior management as needed.
3. Draft and deliver timely, consistent, and systematically detailed audit result summaries on a weekly and on-going basis that maintain compliance with department and business area processes and procedures. Ensure audit documentation concisely describes and substantiates audit findings, and also addresses expected course of action to assure efficient disposition of defects.
4. Develop and maintain domain expertise of business rules specific to the assigned area of audit. Partner with business process owners to develop and maintain a complete understanding of business area process goals and intent.
5. Proactively and continually seek opportunities to increase knowledge and understanding. Learn from experience, others, mistakes and challenges. Ask questions to ensure conceptual understanding of processes and priorities.
6. Develop and maintain expertise within department utilized applications and systems.
7. Meet all applicable audit deadlines and ensure audits are completed within expected turn-around time (TATs)
8. Ensure department performance and production standards are maintained through consistent achievement of departmental goals.
9. Ensure systematic data oriented efforts to improve consumer and/or client services are continually maintained. 95% of this job is related to QM activities
10. Collaborate, coordinate, and communicate across disciplines and departments
11. Attend team meetings and openly participate in discussions regarding operational procedures and quality updates.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate commitment to the Companys core values.
14. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
15. Responsible for routine internal monitoring and auditing of compliance risks, prompt response to compliance issues as they are raised, investigation of potential compliance problems as identified in the course of self-evaluation and audits, correction of such problems promptly and thoroughly to reduce the potential for recurrence as required by applicable state and federal laws, regulations and MPIs Compliance Programs
16. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.