Temporary Quality Assurance Coordinator- Complaints Unit & Fair Hearings (Remote-New York)
Job Introduction
Maximus is currently hiring for a Temporary Quality Assurance Coordinator position! This is a temporary, full time position and is fully remote in the state of New York.
We are looking for an individual with a great eye for details and exceptional communications skills and an interest in the Quality Assurance field. If you're looking for more than a job and want to make an impact in the healthcare industry, then this is the position for you.
Job Summary
Essential Duties and Responsibilities:- Responsible for evaluating staff members on the quality of work performed as measured against project standards, contractual requirements and performance measures.- Assist with the development, design and recommend strategies or activities intended to improve performance in Call Center Operations.- Assist with the development, analysis and distribution of project reports and performance indicators.- Regularly assess the knowledge needs of the staff related to processes and policies regarding the client/contract operations and develop plans to meet those requirements.- Conduct monitoring activities for quality assurance purposes.- Assist with monitoring performance and meeting contractual requirements.- Remain up-to-date on policies and procedures for all operations, assists in developing new procedures, and updates existing procedures when changes occur.- Assist in the production and update of staff resource materials including quick reference guide, matrices, charts, and workflows.- Assist with staff training, as necessary.- Meet all standards established for this position as outlined in the attached performance criteria.- Perform other duties as may be assigned by corporate management.Minimum Requirements:- High School diploma or equivalent with 0-2 years of experience.- May have additional training or education in area of specialization.- Work on assignments that are routine in nature, with responsibilities easily learned on the job.- Acquire job skills and learns applicable policies and procedures to complete routine tasks.- Able to read, understand & perform assignments within prescribed guidelines.- Communicate routine information in a clear and accurate way with internal & external contacts.
Education and Experience Requirements
Essential Duties and Responsibilities:
- Responsible for evaluating staff members on the quality of work performed as measured against project, standards, contractual requirements and performance measures
- Assist with the development, design, training and strategies or activities intended to improve performance in Call Center Operations
- Assist with the development, analysis and distribution of project reports and performance indicators
- Regularly assess the knowledge needs of the staff related to processes and policies regarding the client/contract operations and develop plans to meet those requirements
- Remain up-to-date on policies and procedures for all operations, assists in developing new procedures, and updates existing procedures when changes occur
- Assist in the production and update of staff resource materials including quick reference guide, matrices, charts, and workflows
- Represent CFEEC in Fair Hearings before Administrative Law Judges for disputed decision
- Compile Fair Hearing evidence packages (case files) and handle appropriately (distribute, log, file, etc.)
- Communicate information on Fair Hearing cases directly with state and local agencies, Administrate Law Judges, Plan’s legal representatives, consumer’s legal representative and/or advocates
- Develop Fair Hearing conclusion reports using case notes, hearing information, etc. and present to project management and the client
Minimum Requirements:
- High School diploma or equivalent with 0-2 years of experience working in New York Medicaid Choice programs
- May have additional training or education in area of specialization
- Work on assignments that are routine in nature, with responsibilities easily learned on the job
- Able to read, understand & perform assignments within prescribed guidelines
- Communicate routine information in a clear and accurate way with internal & external contacts
- Must be knowledgeable about Conflict Free Evaluation and Enrollment Center (CFEEC) program policies and procedures, program objectives and enrollment processes
- Capable of presenting at formal case hearings, researching and investigating root causes, and gathering and reporting programmatic data
- Must have strong analytical skills with the ability to successfully handle multiple tasks;
- Proficiency in Microsoft Word, Excel, and other computer software applications
- Excellent organizational, interpersonal, written and verbal communication skills
- Ability to perform comfortably in a fast-paced, deadline-oriented team and independent work environment
- Willingness to travel throughout NY State
Home Office Requirements:
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds