Commonwealth Care Alliance
Quality Assurance Reviewer Associate I (Remote)
This job is now closed
Job Description
- Req#: 5001040584506
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Competitive salary up to $100,000
- Opportunity for career advancement and growth within the organization
- Remote work opportunity
- Supportive and collaborative work environment
- Chance to make a positive impact on quality assurance in healthcare
What to Expect (Job Responsibilities):
- Conduct independent quality reviews of medical claims and Call Center activities
- Review issuance of ID Cards and Welcome Kits for accuracy
- Verify accuracy of Enrollment entries
- Provide immediate error notices and compile review results
- Summarize review results for appropriate leadership
What is Required (Qualifications):
- Bachelor's Degree or equivalent experience
- 3+ years of healthcare claims payor experience, enrollment experience, or Call Center experience
- Experience with quality assurance in the healthcare field
- Knowledge of Medicare plans and processes
- Strong Microsoft Office skills, especially Excel
How to Stand Out (Preferred Qualifications):
- Experience coaching for performance improvement
#HealthcareServices #QualityAssurance #RemoteWork #CareerGrowth #CompetitivePay
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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
Based in Massachusetts, Commonwealth Care Alliance (CCA) is a not-for-profit, community-based healthcare organization dedicated to improving care for individuals who are dually eligible for MassHealth (Medicaid) and Medicare with complex medical, behavioral health and social needs, including persons with disabilities. CCA offers two health plans: Senior Care Options (HMO SNP), for individuals ages 65 and over who have Medicare and MassHealth Standard or only MassHealth Standard; and One Care, a Massachusetts demonstration program for dual eligible individuals ages 21 to 64. These comprehensive health plans provide all the services covered under Medicare and MassHealth, and other benefits as determined necessary by an inter-professional care team in conjunction with CCA’s preferred provider network. For four consecutive years, CCA’s One Care plan received a top consumer rating for quality and access in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) national survey of Medicare-Medicaid Plans (2016, 2017, 2018, and 2019), administered by the Centers for Medicare & Medicaid (CMS).
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