Remote Jobs
MLTSS Quality Assurance Specialist
What's your preference?
Job Description
- Req#: 2019-9626
Employer Industry: Healthcare Insurance
Why consider this job opportunity:
- Salary up to $104,370
- Comprehensive health benefits including Medical, Dental, and Vision
- Generous PTO and paid volunteer time off
- Opportunities for professional development through tuition reimbursement
- Incentive plans and wellness programs to support employee well-being
- Collaborative and innovative work environment
What to Expect (Job Responsibilities):
- Conduct audits on member charts and assessments for compliance with regulatory requirements
- Analyze and document audit outcomes, including error trends, for management follow-up
- Collaborate with the MLTSS/DSNP Department to develop process improvement recommendations
- Present audit reports and findings during Subcommittee meetings
- Organize and prioritize multiple projects related to MLTSS/DSNP oversight activities
What is Required (Qualifications):
- Bachelor's degree preferred or LPN with 5 years of Clinical Case Management experience
- Minimum of 3 years experience in the healthcare delivery system
- Experience in chart reviews, indicators, and databases
- Knowledge of regulatory agency standards and requirements
- Strong PC skills and proficiency in Microsoft Office
How to Stand Out (Preferred Qualifications):
- Experience in managed care in a customer-oriented capacity
- Preferred Licensed Registered Nurse
- Exposure to data compilation and presentation processes
- Familiarity with audit methodologies and procedures
- Knowledge of managed care health care delivery systems
#HealthcareInsurance #QualityAssurance #CareerOpportunity #CompetitivePay #ProfessionalDevelopment
"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."About the company
The best remote jobs for you
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.