Quality Assurance Analyst

2 weeks ago

Costa Mesa, California, United States IMCS Group Full time

Position Overview:

Under the guidance of the Quality Assurance Manager, the Quality Assurance Analyst at IMCS Group undertakes a range of responsibilities to support Quality Assurance initiatives, ensuring smooth patient flow and ongoing communication among the organization, referring physician offices, and internal staff.

The Quality Assurance Analyst embodies a work ethic that aligns with the mission, vision, and values of IMCS Group. Engages in the ongoing Quality Assurance process, maintaining a comprehensive understanding of departmental standard operating procedures, including the utilization of specialized tools, Quality Control standards, and preventive maintenance protocols.

Key Responsibilities:

  • Collaborates with the Quality Assurance Manager in analyzing, interpreting, and translating health plan data, issues, trends, and relationships into actionable strategies and plans.
  • Manages assigned projects while effectively communicating with the Quality Assurance Manager regarding project status, deadlines, and potential challenges.
  • Possesses knowledge of clinical quality programs and risk management projects to ensure the provision of essential analytics that support outreach and daily clinical operations.
  • Validates supplemental data entries within the quality reporting system to guarantee accuracy and compliance with submission standards.
  • Develops and generates reports to assist IMCS Group's leadership and clinical sites, utilizing available analytics and data mining tools, including but not limited to Microsoft Applications (such as MS Access), system-specific reporting tools (e.g., Cozeva, Report Manager, Qlikview), or other relevant reporting software.
  • Supports the submission and audit processes for quality programs, including but not limited to health plan, national, and state-level quality initiatives.
  • Evaluates report requests to ascertain the organization's needs and objectives, identifying the appropriate methodology for data extraction, including sources and criteria, ensuring that the delivered report is accurate, timely, and properly formatted.
  • Maintains and enhances quality and risk internal reporting through data extractions from various systems and databases.
  • Collaborates with business partners and health plans to obtain necessary reports for integration into internal reporting.
  • Works alongside IMCS Group's data teams to validate reports.
  • Reviews patient charts within the electronic medical record (EMR) system to identify issues related to data capture within the quality reporting framework.
  • Ensures the confidentiality and security of Protected Health Information (PHI) in accordance with IMCS Group's policies and procedures regarding compliance.

Required Skills & Experience:

  • A minimum of two (2) years of prior experience in a related field.
  • Exceptional communication skills; customer-oriented; meticulous attention to detail; ability to prioritize tasks and meet deadlines; strong interpersonal skills; capable of working effectively in a team environment.
  • Basic keyboarding skills at 35 WPM.
  • Fundamental knowledge of Microsoft Office Suite, including Outlook, Word, and Excel.
  • Proven ability to interact with all levels of customers (physicians, organizational staff, insurance companies, patients, and family members).
  • Basic understanding of medical terminology.

Preferred Skills & Experience:

  • Bilingual or multilingual candidates are encouraged to apply.
  • A minimum of two (2) years of previous experience within an acute healthcare system environment.

Required Education:

  • Bachelor's degree in a healthcare-related field.

Preferred Education:

  • Master's degree in a healthcare-related field.

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