**Please note: This position is with Nova, a division of Independent Health Corporation (a subsidiary of Independent Health).**
The Quality Assurance Analyst is responsible for developing, delivering, supporting, communicating, and
monitoring an effective quality review program for all functions in the Nova Operations Department.
Including but not limited to:
Claims (Medical, Dental, Vision, Reimbursement Accounts, Repricing)
High Dollar Claims; Cost Containment
Client Performance Guarantees
Quality Improvement Plans
The Quality Assurance Analyst is responsible to perform random quality assessment reviews of work performed within the departments and developing and completing reports including statistics of staff/department performance. The Quality Assurance Analyst also assists with the development and implementation of policies, procedures and standard operating practices across the Operations team as required. The Quality Assurance Analyst, may at times be asked to assist with or facilitate training sessions in order to improve the overall quality of the operations team.
Associates degree from an accredited college preferred; extensive healthcare or systems experience will be considered in lieu of degree.
Two (2) years health insurance related claims analyst experience or other experience in health insurance, or quality monitoring in an operations environment may be accepted.
Strong computer software experience required. Proficient in Microsoft Office programs, specifically Excel and Word and is familiar with statistics and metric reporting.
Excellent organizational, written and verbal communication, planning and reporting skills, with the ability to assume responsibility and work independently, as well as in a team environment. Demonstrated ability to work well and communicate to all levels of management and front line employees.
Proven ability to use independent judgment and solid reasoning skills when rendering decisions and troubleshooting system issues.
Ability to work under pressure, delivers on deadlines, and demonstrates flexibility to change direction when required.
Knowledge of or an understanding of how all operational areas affect one another and the organization as a whole.
Must exhibit initiative, decisiveness and creativity, along with self-motivation and the ability to assume responsibility and maintain strict confidentiality.
Understands the importance of maintaining the physical and technical security and privacy of protected health information (PHI).
Independent Health is an equal opportunity employer.
Independent Health - 19 months ago