What are the responsibilities and job description for the Manager, Quality Assurance position at Blue Cross of Idaho Health Service, Inc.?
Blue Cross of Idaho is looking for a Manager of Quality Assurance to oversee and provide expertise related to the quality assurance and improvement programs for the Enterprise Business Operations (EBO) departments. Working with the Director of Business Transformation, this role is accountable for implementing, managing, and continually improving quality assurance programs for the core processes and outputs of these teams - such as customer service calls, enrollment transactions, member claims, and more. Responsibilities will include conducting ongoing quality assessments, adjudicating accuracy disputes, maintaining feedback loops with EBO leaders, replying to audit findings, and spearheading process improvement efforts.
This position is onsite, located in Meridian, Idaho. #LI-Onsite
To be considered for this opportunity, you have :
Experience : 7 years' of experience to include quality assurance / audit and people management experience.
Education : Bachelor's Degree in related field; or equivalent work experience (Two years' relevant work experience is equivalent to one-year college).
In this role, we will ask you to :
- Ensure metrics relative to quality and accuracy are reviewed and propose areas for improvement to processes, methodologies and deliverables.
- Lead all aspects of the development and delivery of formal quality assurance programs for EBO.
- Evaluate quality program effectiveness, through analysis of quality review outcomes, revising programs accordingly.
- Ensure documentation for knowledge management is updated and consistent.
- Review, evaluate, and report operations results to overall and individual performance against established standards and samplings. Provide feedback, conduct process reviews, and analyze metrics that identify areas of improvement. Develop and implement process improvement plans.
- Coordinate the review and response to Internal Audit findings.
- Perform other duties and responsibilities as assigned.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
