Senior Quality ConsultantPrimary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix Apply
Provides consultation on the quality of QNXT configurations for contracts, provider information, and health plans. Researches, manipulates and prepares complex data to document program activities and reports on its results. Provides oversight to data quality and provides feedback to various areas in order to improve service delivery and enhancement to design efforts. Develops a consultative relationship with internal customers.
68806Fundamental Components: Fundamental Components & Physical Requirements include but are not limited to:
Perform related duties as assigned by CSRA management, including but not limited to:
- Completes all required quality activities required for the maintenance of existing health plans and implementation of new health plans.
- Assists with performing focused audits when requested.
- Identifies process improvements for the CSS or HPRA department for increasing work quality and reducing Remedy ticket TAT.
- Represents CSS or HPRA as the quality process expert for various internal and external meetings as required.
- Trains new staff as required to work in the CSS or HPRA QC group.
- Maintains a 100% ticket target volume for SCR/IIF/Project QC assignment activities.
- Provides Leadership/Coaching/Mentoring; to others on the CSS or HPRA team.
- Directs the implementation of program specific information through education, technology, organizational methods and procedures.
- Influences enhancements to business processes and system infrastructure to improve data quality availability and access.
- Conducts quality analysis on completed tickets and provides recommended configuration revisions and clarifications for solution documentation.
- Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
- Translates complex data into constructive data and information and makes recommendations.
- Illustrates complex information in a clear concise manner through communication and job aids.
- Provides workgroup support on projects.
- Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access.
- 3-5 years of data interpretation and quality analysis experience.
- Extensive experience with databases as well as interpretation and manipulation of related data.
- Extensive experience with provider contracts, claims payments, and benefits.
- Healthcare background.
- Excellent verbal and written communication skills.
- Excellent attention to detail and analytical skills.
- Associate's degree, technical certification or equivalent work experience.
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