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Quality Assurance Coordinator

2 months ago

Cincinnati, Ohio, United States CorVel Healthcare Corporation Full time
Job Description

Job Summary: We are seeking a highly skilled Quality Assurance Coordinator to join our Pharmacy Solutions team at CorVel Healthcare Corporation. As a Quality Assurance Coordinator, you will play a critical role in ensuring the consistent delivery of our total workers' compensation solution through the development, implementation, and ongoing utilization of quality assurance tools and training.

Key Responsibilities:

  • Quality Assurance: Conduct quality reviews/audits to ensure appropriate management of claims and offices, score office performance, and make suggestions and follow-up to ensure offices have taken action on improvement recommendations.
  • Training and Development: Identify and participate in training and developmental needs of claims staff, including training/re-training of all offices on existing best practices and new procedures, including usage of the CorVel claim system.
  • Support and Liaison: Provide back-up for incoming Pharmacy team calls, complete daily rejection report lines, quality assurance—gather and handle forwarded daily QA emails, and provide back-up duties for completing outstanding emails.
  • Team Quality Assurance: Provide team quality assurance for individuals to track monthly quality assurance, provide feedback to individual team members, and process compounds as requested by specialists.
  • Reporting and Documentation: Create quality assurance monthly and yearly reports for management, create and keep current-comprehensive standard operating procedures for Pharmacy team use, and create and implement new-hire and ongoing professional development training documents and testing for the Pharmacy team.
  • Additional Duties: Phone monitor reps on a rotating basis, provide business-writing training for team members, publish quarterly department newsletter, complete miscellaneous pharmacy projects, and send anniversary emails to team.

Requirements:

  • Education and Experience: Minimum one year CorVel pharmacy benefit management experience, Pharmacy Specialist III, and Certified Pharmacy Technician.
  • Skills and Knowledge: Excellent professional and effective verbal and written communication skills, ability to identify problems and get the broad view for potential and existing quality assurance cases, strong knowledge and experience in quality assurance and training programs, and strong organizational skills.

About CorVel Healthcare Corporation: CorVel Healthcare Corporation is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health, and disability management industries. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. We offer a comprehensive benefits package for full-time regular employees, including medical, dental, vision, long-term disability, health savings account, flexible spending account options, life insurance, accident insurance, critical illness insurance, pre-paid legal insurance, parking and transit FSA accounts, 401(k), ROTH 401(k), and paid time off.