Quality Assurance Manager

Job Summary

To ensure accurate adjudication of cases, the full-time Quality Assurance Manager will oversee the quality assurance program, conduct audits, and provide training and coaching, working remotely and requiring weekend and holiday availability.

Key responsibilities

• Oversees, plans, and monitors the quality assurance program to ensure accuracy and consistency in decisions
• Conducts audits and prepares reports to identify trends and improvement opportunities based on data analysis
• Develops training opportunities for staff based on audit findings to enhance overall quality performance

Required qualifications

• Associate's degree or 60+ credit hours towards a Bachelor's degree in healthcare or related discipline, or equivalent experience
• Five years of medical dispute, Medicare appeals, or clinical experience in a healthcare setting
• Three years of management or supervisory experience
• Two years of training experience in a relevant field
• Experience in Medicare Part C related appeals activities is preferred