Job Summary:

Responsible for audit of clinical data quality as assigned and the analysis of RHRP-3 services to ensure compliance of all RHRP-3 related Service Component business rules. Provides analysis for corrective actions to ensure all requested services are processed accurately.

Essential Duties and Responsibilities:

• Document quality issues and performance measures for management review
• Analyze data and observations and write result summaries to validate deviations from existing standards
• Recommend modifications to existing standards, methods, or procedures
• Interact with operations, IT personnel and supervisors
• Review, analyze, and implement processes and report trends to promote customer satisfaction
• Conduct internal quality assurance of RHRP-3 services
• Compile strategic information and develop reports to monitor quality effectiveness of automation
• Ensure compliance and understanding of quality requirements
• Manage special focused projects and make recommendations as appropriate
• Mentor and train team members and provide resource support with daily tasks
• Perform other duties and responsibilities as assigned

Competencies:

• Excellent verbal and written communication skills
• Excellent computer and presentation skills
• Strong business development, organization, analytical and problem-solving skills
• Strong medical background
• Demonstrated data gathering and reporting skills
• Ability to work in a team-oriented environment
• Proficient with MS Word, Excel, Access, and PowerPoint
• Ability to excel at details and multi-task
• Must be willing to travel up to 20%

Education and/or Experience: (includes certificate & licenses)

• Bachelors Degree from an accredited college in a related discipline or equivalent experience/combined education
• 7 to 10 years of relevant professional experience
• 3 to 5 years’ experience in performing Quality Reviews in a health care environment
• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, people with disabilities protected under law, and protected veteran status.

Experience

• 3 - 5 years: Relevant professional experience in performing Quality Reviews in a health care environment

Education

• Bachelors or better

Skills

• MS Office
• Executing Multiple Tasks
• Medical Terminology
• Computer Literacy
• Written Communication
• Verbal Communication
• Team Player

Behaviors

• Team Player: Works well as a member of a group
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
• Dedicated: Devoted to a task or purpose with loyalty or integrity

Motivations

• Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work
• Self-Starter: Inspired to perform without outside help
• Goal Completion: Inspired to perform well by the completion of tasks
• Growth Opportunities: Inspired to perform well by the chance to take on more responsibility

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)