Job Title:Quality Analyst
Number of Positions:1
Location:Albuquerque, NM
Location Specifics:Hybrid Position
Primary Job Responsibilities:PRIMARY JOB RESPONSIBILITIES: The following are upheld by the Quality Analyst:
- Role model and live the company values and behaviors. Know the company vision, mission, and objectives and continually communicate and reinforce these to fellow Team Members.
- Design and implement annual formalized data-driven quality improvement strategies and address customer and stakeholder needs.
- Proactively support quality assurance process improvement initiatives.
- Design and perform risk assessments for quality assurance.
- Assist departments in defining and implementing quality performance indicators.
- Support strategic quality improvement projects by providing business owners with data-driven insights and recommendations.
- Design, create, and implement quality reporting and perform analysis.
- Conduct ad hoc data analysis as directed.
- Develop and implement standardized performance metrics and guarantees, report on individual groups and the entire book of business.
- Assure compliance with regulatory reporting requirements through generating timely and accurate compliance reports.
- Maintain quality on processes, data integrity of the business intelligence unit, and compliance through risk management.
- Collaborate annually with the Director of Decision Support to develop and implement a comprehensive plan for identifying and prioritizing quality initiatives.
- Monitor and report on performance guarantees written in vendor contracts.
- Conduct claims review auditing and review of claims processing.
- Work with operations to develop a quality audit process for monitoring, reporting, and improving call center quality.
Minimum Requirements:MINIMUM QUALIFICATIONS:The following are expected of the Quality Analyst:
- A values-driven, high-performance mindset.
- Excellent time management skills and ability to consistently meet deadlines.
- Strong multitasking abilities to manage multiple tasks and deadlines effectively.
- Exceptional understanding of processes and the ability to identify root causes.
- Strong analytical, critical thinking, and problem-solving skills.
- Effective communication skills, with the ability to interact well with cross-functional teams.
- Availability to work in the office during regular business hours.
- Able to work in an open office environment.
- Legally authorized to work in the United States.
- Successfully pass a 7-year background check and drug test.
Education/Experience:- Bachelor's degree in related field or equivalent experience.
- 2-4 years of experience in quality assurance, data analysis, or business process improvement, preferably in a health care setting.
- Advanced knowledge of Excel, SQL, or Business Intelligence tools (Looker, PowerBI, Tableau, etc.)
- May accept any suitable accept any suitable combination of education, training or experience.
The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.