To get more informatin on this positions or to apply directly, you can visit the following link:https://rapidinterviews.com/job/qa-auditor-manager-with-healthfirst-2/The position listed below is not with Rapid Interviews but with Healthfirst

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<p /><strong>Company Overview:</strong> <p />Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area. <p />Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst's commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers: <ul><li>Dream Big, Plan Wisely </li><li>Break Down the Walls </li><li>Think Critically, Speak Up, Deliver with Pride </li><li>Inspire Through Trust, Lead By Example </li><li>Be Unstoppable <p /><strong>Position Summary:</strong> <p />The Quality Assurance Manager leads the QA Auditors in conducting detailed audits, ensures strong partnership with auditors and operations business unit management in the identification of developmental areas, creation and delivery of audit and other solutions resulting in staff development. The QA Manager oversees quality monitoring functions and is responsible for assuring that standards are being evaluated fairly and consistently in compliance with policies, procedures, and quality standards in all Healthfirst Operations processes and supporting systems. The QA Manager demonstrates understanding and applicability of different Quality Management methodologies and Problem-Tracking& Feedback Loop while also building constructive relationships with Operations process owners. <p /><em>Healthfirst is an Equal Opportunity Employer and does not discriminated against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.</em> <br /><br /><b>Responsibilities</b><br /><br /><p /><strong>Duties& Responsibilities:</strong> <ul><li>Manage QA Auditors to conduct process reviews and provide oversight in the creation and facilitation of audits across multiple operational areas. </li><li>Ensure individuals and the team meet or exceed performance goals. </li><li>Direct employees in matters of quality and inspection, and assist in disciplining personnel when standards are not met. </li><li>Maintain procedures and programs to ensure Operational units meets organizational and regulatory standards for proper function, quality, and Member/Provider acceptance. </li><li>Produce, analyze and interpret reports on trending of audits evolutions and summarize to operations leadership. </li><li>Serve as point of escalation for audit disputes. </li><li>Conduct comprehensive needs analysis to ensure that audit programs fulfill the needs and objectives of the company </li><li>Partner and consult with internal organizations to create and execute audit plans. </li><li>Contribute to creating new processes or services to optimize operational areas. </li><li>Contribute to the overall success of the Quality Assurance Organization by identifying ways to continuously improve the learning process. </li><li>Hold staff 1:1 and monthly team meetings. </li><li>Ensure team supports and adheres to all improvement initiatives. </li><li>Monitor and manage staff member performance. </li><li>Provide coaching to quality staff based on quality production/service results and develop improvement plans when needed. </li><li>Maintain high morale by inspiring representatives through reward and recognition programs. </li><li>Investigate trends, identify root problem, report issues, and collaboratively works with specific team/individuals to resolve issues. </li><li>Supervise department staff including recruiting, hiring and training staff. </li><li>Demonstrate or develop deep understanding of all Operations processes and supporting systems </li><li>Additional duties as assigned. <br /><br /><b>Qualifications</b><br /><br /><p /><strong>Minimum Qualifications:</strong> <ul><li>Previous work experience in an auditing function conducting root cause analysis. </li><li>Experience supervising a team of employees, both direct and indirect teams (30-40 employees) </li><li>Demonstrated experience developing and performing tests; implementing statistics and process control tools; and maintaining effective compliance and corrective action procedures. </li><li>Demonstrated knowledge in creating reports, surveys and quality audits for management or external clients. </li><li>Leadership experience </li><li>Experience communicating with cross-functional individuals within an organization. </li><li>Experience leading project groups and independent projects within a corporate setting. </li><li>Skilled in creating documents, Vlookups and pivot tables within Microsoft Excel. </li><li>Experience creating presentations using Microsoft PowerPoint. </li><li>Exposure to corporate email and Microsoft Word by creating and editing documents. </li><li>Experience with troubleshooting and process improvement. </li><li>High School Diploma or GED. <p /><strong>Preferred Qualifications:</strong> <ul><li>Bachelor's degree from an accredited institution. </li><li>ICD10 certification </li><li>Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family </li><li>Experience managing a Quality Assurance team. </li><li>Experience in Healthcare/Health Plan customer service and claims processing </li><li>Demonstrated experience or deep understanding of healthcare Operations processes and supporting systems such as Claims Processing, Enrollment& Billing, and Member Services. <br /> Associated topics: chief program officer, cpo, manage, manager, management, monitor, product manager, project manager, relationship manager, task

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