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EL Review Specialist

2 months ago

Princeton, New Jersey, 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 an EL Review Specialist, you will play a critical role in ensuring the quality of our services and maintaining contractual performance requirements.

Job Summary:

The EL Review Specialist will be responsible for performing quality assurance reviews on eligibility determination cases, ensuring compliance with the Quality Assurance Plan and contractually required performance 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 compliance with quality standards and contractual 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
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
  • Excellent oral and written communication skills, strong interpersonal skills, and superior organizational abilities
What We Offer:
  • $21.00 per hour pay rate (bi-weekly pay)
  • Full-time schedule (40 hrs. a week)
  • Career growth opportunities
  • PerkSpot- employee discount program
  • Full benefit options

Conduent State Healthcare, LLC is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.