Quality Assurance Specialist

2 weeks ago


London, Kentucky, United States Conduent State Healthcare, LLC Full time
Job Title: EL Review Specialist

Conduent State Healthcare, LLC is seeking a highly skilled EL Review Specialist to join our team. As a key member of our quality assurance team, you will play a critical role in ensuring the accuracy and integrity of our eligibility determination processes.

Job Summary:

The EL Review Specialist will be responsible for reviewing eligibility cases to ensure compliance with contract requirements and quality assurance standards. This role requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills.

Key Responsibilities:
  • Review eligibility cases to ensure accuracy and compliance with contract requirements
  • Maintain technical and program policy proficiency in the NJ Family Care program
  • 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
  • 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
Requirements:
  • Associates degree required; relevant quality assurance experience can be substituted for education on a one-for-one basis
  • 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
What We Offer:
  • Competitive hourly rate of $18.00
  • Full-time schedule (40 hours/week)
  • Opportunities for career growth and professional development
  • Full benefits package, including health insurance, paid time off, and retirement savings plan

Conduent State Healthcare, LLC is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees. If you are a motivated and detail-oriented individual who is passionate about quality assurance, we encourage you to apply for this exciting opportunity.



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