Operations Coordinator Lead

5 days ago

Easton, Pennsylvania, United States Qlarant Full time

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high-quality, safe, and efficient delivery of healthcare and human services programs.

We have multiple lines of business, including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities.

Qlarant is also a national leader in fighting fraud, waste, and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.

Job Summary:

Coordinates a variety of operational functions and coordinates activities across the business unit by performing the following duties. Responsible for supporting management in responding to customer needs and for coordinating workload assignments for Operations Coordinator.

Key Responsibilities:

  • Liaison to CMS and State governmental entities to obtain/provide information, identify issues, and assist with timely responses to inquiries regarding the MCP contract.
  • Responds to client inquiries via written or oral communications.
  • Ensures contract compliance by monitoring deliverables, contract requirements, and communicating Medicare change requests.
  • Works with other business units to ensure the effective coordination of objectives/deliverables, establish permissions in systems, perform quality review of deliverables to ensure compliance in accordance with applicable regulations within the scope of work, managing activities, and facilitating project by setting priorities.
  • Coordinate and manage the transition of workloads, and serve as the interface with other entities.
  • Contractor Administrator for CMSARTs system.
  • Writes reports, prepares presentations, and ensures the timely approval by Medicaid Program Director of deliverables.
  • Provides training and technical advice to team members.
  • Coordinates new CMS User ID set ups and background verifications.
  • Works with Quality Director/Officer on ISO initiatives to improve operational systems, processes, and policies to improve information flow, management reporting, business process, and organizational planning.
  • Facilitates project logistics such as meetings, conference rooms, conference calls, etc.
  • Participates and/or leads internal/external committees as assigned.
  • Supervises staff in the operational area. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.

Requirements:

  • High school diploma or GED required.
  • Associates Degree in business preferred.
  • At least 3 years experience in an administrative position; or an equivalent combination of education and experience.
  • Prior experience working on government contracts essential.
  • Working knowledge of Medicare and/or Medicaid protocols for Fraud and Abuse investigations are preferred.

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