Manager of Quality Assurance

Essential Job Duties: Assumes responsibility for personnel related duties including interviewing, disciplinary actions, payroll and enforcing required rules and regulations, consulting with the director, as necessary. Responsible for accurate, timely and efficient review of quality assurance activities. Reviews may include staff performance, department procedures and workflows and system logic and functions. Responsible for identifying the need for and development of new reviews. Identifies and reports information system needs within the department and suggests potential system enhancements or other solutions. Partners with all departments in the organization to develop, implement and evaluate quality assurance efforts. Prepares and delivers quality assurance progress reports to upper management. Provide support and leadership to department staff while managing overall performance. Maximizes staff performance through regular team meetings, effective training, on-going 1:1 performance discussions, as well as formal performance review and meaningful development. Performs human resource management duties including but not limited to hiring, training, and time and performance management. Consults with leader and Human Resources as required. Participates in problem solving and prioritizing review activities and oversees the completion and reporting of review activities for service level agreements and communicating results with leadership. Serves as the primary point of contact for internal and external audit activities, responds to findings related to the quality assurance area, responds to formal auditreports and communicates results to internal staff. Assists with the development, implementation and execution of the quality assurance plan for the organization. Provides leadership and evaluation of the team to help ensure productivity and continuous process improvement. Creates/revises/implements quality assurance standards, policies and procedures; maintains and routinely updates matrix of all department policies; monitors adherence and reports on department efforts. Other duties as assigned Skills Required: Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions as well as communicate effectively with internal staff as well as external parties Must be able to develop and implement policies and procedures, accept and institute change and resolve issues at the individual and group level Ability to organize one's work and space to ensure successful completion of assigned tasks within the identified timeframe Ability to adapt to new circumstances, information and challenges in a fast paced environment Ability to work independently, as well as part of a team Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health  Knowledge of health care industry practices and compliance   possess a moderate level of mathematical aptitude Demonstrated organization, facilitation, communication and prioritization skills Ability to motivate and successfully guide a team to reach goals on time and within budget Advanced Skill with Microsoft Office Suite (Word, Outlook, Excel) Minimum Education Required: Bachelor's degree or equivalent work experiencerequired Master's degreepreferred Minimum Related Years of Experience (per minimum education) Required: 5 or more years health care or health insurance experience is required. 3 or more years of experience working in one or more of these areas is required: claims processing, monitoring/auditing, configuration, finance, enrollment customer service, appeals and grievances or pharmacy. 2 or more years of prior leadership experiencerequired 3 or more years working in a quality assurance or auditing role required. MANAG01457
Salary Range: NA
Minimum Qualification
5 - 7 years

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