Quality Assurance Specialist overseeing billing and documentation for compliance in addiction and mental health services. Collaborating with staff to improve accuracy and quality of client documentation.
BC
Hybrid NCQA Accreditation Analyst
Posted 4 months ago
About the role
- NCQA Analyst leading accreditation compliance activities, monitoring standards and collaborating with teams in a healthcare company. Responsible for audits and quality improvement initiatives.
Responsibilities
- Lead accreditation compliance activities including review and interpretation of the standards
- Monitor multiple areas' compliance
- Develop and implement quality improvement activities to improve compliance
- Maintain full three-year accreditation status and monitor NCQA processes/standards
- Conduct/participate in audits of areas to ensure compliance with NCQA activities
- Analyze audit results and make recommendations for improvements
- Prepare formal documentation of audits
- Present findings to relevant committees and monitor corrective action plans
- Provide HEDIS support for multiple departments
- Coordinate preparation of on-site audits conducted by external bodies
- Review medical records for coding validations
Requirements
- Bachelor's in a job related field
- 5 years of health insurance industry, audit/compliance/investigations, project management, or corporate level related experience
- If Master’s degree, required work experience is 3 years
- Ability to effectively communicate both verbal and in writing to all levels of the organization
- Knowledge/understanding of medical terminology and medical coding
- Excellent analytical or critical thinking and problem solving skills
- Ability to make sound decisions and work independently
- Ability to exercise confidentiality and discretion
- Excellent presentation skills with strong attention to detail
- Microsoft Office skills
Benefits
- Subsidized health plans
- Dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Education Assistance
- Service Recognition
- National discounts to movies, theaters, zoos, theme parks and more
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
QA Team Lead at IC Markets driving quality strategy and automation for trading platforms. Leading a skilled team to implement robust automation frameworks in a dynamic FinTech environment.
QA Automation Engineer for full - stack software development company passionate about creating web and mobile products. Work with customers worldwide while contributing to test plans and automation.
Quality Assurance Specialist ensuring compliance with quality standards in MedTech company. Collaborating with cross - functional teams and maintaining quality improvement processes.
Senior Softwaretester focusing on automation and scalability in software testing at TAIFUN Software. Collaborating with QA, development, and product management teams to enhance product quality.
Senior Softwaretester developing scalable, stable test automation with AI - supported processes. Collaborating with QA team and refining testing frameworks at OneQrew in Germany.
Senior Customer Quality Engineer representing Customer Quality within Intel Foundry Services. Responsible for driving quality processes and advocating for customers in a fast - paced environment.
Associate QA Engineer in automotive insights team delivering automated and manual testing solutions. Collaborating with developers to ensure quality metrics alignment and effective test strategies.
Senior Quality Engineer validating complex data - driven applications for Disney. Collaborate with teams to ensure software quality throughout the development lifecycle.
QA Analyst supporting functional testing for public sector projects with a focus on agile methodologies. Collaborating with teams to ensure quality and test automation practices.