Supervisor, Medicare Quality
Diversified RPO - Harrisburg, PA

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Diversified Service Options, Inc. (Diversified) is headquartered in Jacksonville, FL. Diversified was created in 1998 to address the enterprise-wide, long-term government business strategies. Diversified has ownership in multiple companies, which along with Diversified have one common missionto provide the best value administrative services available, primarily in the government- sponsored healthcare market. Diversified provides certain shared services for its subsidiary operating companies.
Diversifieds wholly-owned subsidiaries include First Coast Service Options, Inc. (First Coast) and Novitas Solutions Inc. (Novitas), which are government administrative services contractors that provide administrative and claims processing services for state and federal health care programs such as Medicare and Medicaid.
Guided by our company values of doing the right things, the right way, Diversified companies are committed to conducting our business with a high level of integrity, continuously improving our organization and business processes and providing operational excellence and fiscal responsibility in our service to our customers.

JOB DUTIES
  • Provide supervisory oversight of the activities of data analysts, inspectors and clerical support staff. 20%
  • Plan, coordinate and execute the day-to-day activities related to maintaining the system of internal controls for the business unit. 20 %
  • Plan, coordinate and execute the day-to-day activities related to maintaining the quality management system for the business unit. 20%
  • Plan, coordinate and execute process audits in accordance with the schedule approved by senior management for the business unit. 20 %
  • Plan, coordinate and execute the daily activities related to supporting the continuous improvement program for the business unit. 20%
  • Perform other duties as assigned.
  • Pursue self-development by attending client meetings, seminars, and workshops on skills and issues relevant to the position.

REQUIRED QUALIFICATIONS
  • High School Diploma
  • 3-5 years as a supervisor or analyst in a Medicare Fee for Service operation.
  • Thorough understanding of the CPIC Certification Process required by CMS and the guidance provided by the GAO on internal controls.
  • Extensive knowledge of the ISO 9001:2000 Standard requirements and their application within the Medicare Fee for Service unit.
  • Knowledge of quality management principles and tools including Statistical Process Control, Six Sigma, Balanced Scorecard, quality system auditing, inspection sampling techniques, and Total Quality Management.
  • Demonstrated project management and communication skills.

PREFERRED QUALIFICATIONS
  • Bachelor of Science degree in business administration or a related field.
  • ASQ Certified Quality Auditor or other equivalent certification.
  • ASQ Certified Quality Improvement Associate or other equivalent certification.

This Division is responsible for:
Interfacing with the senior management of the business unit, the Diversified Integrity Office, Diversified Corporate Audit, representatives from CMS, and external auditors. Managing activities for providing the senior management of the business unit reasonable assurance of an effective and efficient system of internal controls exist, including the maintenance of a certification process for CMS reports and internal controls. Ensuring the maintenance of a Compliance Program consistent with CMS requirements. Pursuing all activities to assure compliance with the most current version of the ISO Standard for Quality Management Systems. Promoting a culture of compliance, process efficiency, and continuous improvement throughout the business unit. Compiling and analyzing quality performance data and reporting it to senior management.
ADDITIONAL INFORMATION
The incumbent should observe all applicable laws, regulations, company and divisional policies and procedures, and should approach business decisions with sound personal and professional ethics to reflect Diversified core values, Code of Business Conduct and the Integrity Process. The incumbent should foster a reprisal free environment to promote open and constructive communication. The incumbent should also demonstrate support of all ethics and compliance initiatives such as participation in the Integrity Process or compliance training and to consistently demonstrate support of Diversified core values, Code of Business Conduct and the Integrity Process through management decisions.

The incumbent shares responsibility for quality with every other member of Diversified. As part of this responsibility, the incumbent is accountable for identifying quality-related problems and notifying management when they believe quality is being compromised. Furthermore, the incumbent is expected to recommend process improvements designed to improve accuracy, timeliness of processing, and/or eliminate manual effort required.

All employees must meet all CMS and Diversified Service Options security requirements.

This job requires the willingness and ability to report to work on a regular and timely basis and may require working irregular hours, holiday and/or weekends.

Diversified Service Options is an Equal Employment/Affirmative Action Employer.

Diversified RPO - 13 months ago - save job - block
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