Quality Review and Audit Supervisor - Enterprise Operations - Remote

The job profile for this position is Quality Review and Audit Supervisor, which is a Band 3 Management Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

Position Scope: Manage a quality team of 15-20 reviewers in a virtual environment as part of the Enterprise Operations Claim Quality Team. Manages inventory and the feedback processes associated with quality. Partners with internal business owners to ensure the appropriate quality outcome. Maintains feedback data base and tools. Supports developing process improvement plans and Manages projects that support the improvement of the customer experience. Responsible for the delivery of customer experience impact through the quality program.

Summary description of position: This position is responsible for managing a Enterprise Operations Claim Quality Team. Partner with internal business owners to improve customer experience.

Responsibilities:

• Responsible for executing quality management strategies
• Develop a strong relationship with internal business owners
• Maintain a strong rapport with the Enterprise Operations GSP partners
• Responsible for quality results for Enterprise Operations Claim Quality program
• Manage a team of quality review staff members within a live and/or post pay Claim Quality Program
• Participates in efforts to identify operational improvement opportunities that have a direct impact on the customer, provider, or vendor partner.
• May be directly involved in complex operational audits or regulatory inquiries and provide expertise and guidance on technical or procedural issues.
• Partner with Operations Managers, Quality Reviewers/Validators and Coaches to ensure negative customer experiences are assigned appropriately and feedback is shared.
• Have Regular Team Meetings, Huddles, and 1/1's to understand your teams' needs and barriers
• Utilize the eMOS Program to drive efficiencies
• Build Out Weekly, Monthly, and Yearly capacity plans to understand overall staffing needs

Requirements:

• High School Diploma or equivalent required
• Bachelor's Degree or equivalent work experience (preferred)
• 3+ years of direct people Management experience (required)
• 3+ years of Operations People Management experience (preferred)
• 3+ years of claim experience (preferred)
• Highly developed decision-making and problem-solving skills (required)
• Solid background in performance management and employee coaching and motivation (preferred)
• Strong written and verbal communication skills (preferred)
• Ability to handle multiple assignments, projects and deliverables simultaneously (required)
• Ability to work under pressure and flexible hours (required)
• Ability to manage in a virtual environment (preferred)

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 57,600 - 96,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit .

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this .

Qualified applicants with criminal histories will be considered for employment in a manner
consistent with all federal, state and local ordinances.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.