Description

Providence caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Providence is calling a Quality Assurance Manager who will:

• Be responsible for self-insured insurance program’s Medicare Secondary Payer Reporting requirements
• Ensure NPDB settlement reports are submitted timely and accurately
• Promptly and accurately submit regulatory reports to state governing agencies within Providence’s footprint
• Manage Payor Contracting Requests, including running data reports and providing appropriate loss information
• Timely and accurately report claims to excess carriers
• Complete Next of Kin searches
• Provide educational support to claims professionals
• Review, revise, and develop policies and procedures, as needed and upon request
• Run metrics reports
• Work collaboratively with fellow teammates
• Manage multiple time-sensitive priorities
• Work independently in a fast-paced environment
• Be adaptable

Providence is welcoming 100% remote work for residents who reside in the following States:

• Alaska
• Washington
• Oregon
• Montana
• Idaho
• California
• Nevada
• New Mexico
• Texas

Required qualifications for this position include:

• Bachelor's Degree in Management, Administration, Organization, Social Work Administration, or another related field of study -OR- a combination of equivalent education and experience
• 5 years of experience in quality assurance working with liability claims and/or insurance

Preferred qualifications for this position include:

• Master's Degree in Management, Administration, or another related field of study
• Coursework/Training: Training in risk, claims, and insurance
• Applicable certifications in quality assurance or education
• 2 years of experience developing policies and procedures and education for department in claims and/or insurance
• Civil Tort claims handling experience
• Risk Management Experience
• Experience working with Medicare Secondary Payor Reporting
• Experience handling Payor Contracting requests
• Experience with State and Federal settlement reporting
• Regulatory experience
• Experience working within a healthcare organization

Salary Range by Location:

AK: Anchorage:

• Min: $44.24
• Max: $70.03

AK: Kodiak, Seward, Valdez:

• Min: $46.11
• Max: $73.00

Washington: Western:

• Min: $46.11
• Max: $73.00

Washington: Southwest - Olympia, Centralia & Below:

• Min: $44.24
• Max: $70.03

Washington: Tukwila:

• Min: $46.11
• Max: $73.00

Washington: Eastern:

• Min: $39.36
• Max: $62.32

Washington: South Eastern:

• Min: $41.24
• Max: $65.29

Idaho:

• Min: $39.36
• Max: $62.32

Oregon: Portland Metro Region:

• Min: $44.24
• Max: $70.03

Oregon: All cities outside of Portland:

• Min: $41.24
• Max: $65.29

California: Northern California:

• Min: $51.74
• Max: $81.90

California: Humboldt:

• Min: $46.11
• Max: $73.00

California: Southern California:

• Min: $46.11
• Max: $73.00

California: Bakersfield:

• Min: $44.24
• Max: $70.03

Montana: All cities outside of Great Falls:

• Min: $35.62
• Max: $56.38

Montana: Great Falls:

• Min: $33.74
• Max: $53.42

Nevada:

• Min: $46.11
• Max: $73.00

New Mexico:

• Min: $35.62
• Max: $56.38

Lubbock, Levelland, Plainview TX:

• Min: $33.74
• Max: $53.42

TX: Austin, Dallas, Houston, San Antonio:

• Min: $44.24
• Max: $70.03

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 281506

Company: Providence Jobs

Job Category: Financial Transactions

Job Function: Health Plans Services

Job Schedule: Full time

Job Shift: Day

Career Track: Business Professional

Department: 4008 SS RIS

Address: CA Irvine 3345 Michelson Dr

Work Location: Providence Health System Office-Irvine

Pay Range: $See Job Posting - $See Job Posting

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.