Supervisor, Medicare Advantage Quality Operations Lead

4 weeks ago


Columbia, South Carolina, United States PGBA Full time

Job Summary

We are seeking a highly skilled Quality Operations Supervisor to join our Medicare Advantage team at PGBA. In this role, you will be responsible for leading team initiatives and project oversight, including coordinating work efforts among the team and internal departments.

Key Responsibilities

  • Lead day-to-day operations and report key metrics to management on a regular basis.
  • Provide guidance for special training, data validation, project implementation, and employee coaching.
  • Meet with management team to review active and planned work efforts and develop strategic plans.
  • Schedule review sessions to obtain feedback from staff, troubleshoot issues, and ensure staff have adequate resources to complete assigned projects.
  • Plan detailed projects and organize concurrent initiatives through well-prepared staff training and resource alignment.

Requirements

  • Bachelor's degree or degree equivalency: 4 years job-related work experience or Associate's and 2 years job-related work experience.
  • 4 years of project administration, work coordination experience in a healthcare environment or similarly complex environment, including experience in a supervisory role or team lead role.
  • Strong organizational, leadership, decision-making, analytical, problem-solving, interpersonal, and project management skills.
  • Excellent verbal and written communication skills.
  • Ability to persuade, negotiate, and influence.
  • Highly proficient PC skills.
  • Basic business math proficiency.
  • Analytical and critical thinking skills.
  • Basic knowledge of information systems environments and concepts.
  • Flexibility to adapt to changing business, client, and project needs.
  • Ability to balance workload for several work requests simultaneously.
  • Basic understanding of resource planning and organizational impacts.

Preferred Qualifications

  • Strong HEDIS experience.
  • Experience educating providers on quality metrics.
  • Registered Nurse.

What We Offer

  • 401(k) retirement savings plan with company match.
  • Subsidized health plans and free vision coverage.
  • Life insurance.
  • Paid annual leave – the longer you work here, the more you earn.
  • Nine paid holidays.
  • On-site cafeterias and fitness centers in major locations.
  • Wellness programs and healthy lifestyle premium discount.
  • Tuition assistance.
  • Service recognition.
  • Incentive Plan.
  • Merit Plan.
  • Continuing education funds for additional certifications and certification renewal.

What to Expect Next

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.



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