What are the responsibilities and job description for the Quality Examiner - PIO position at BlueCross BlueShield of Tennessee?
The PIO Quality team at BlueCross BlueShield of Tennessee is hiring a Quality Examiner.
We’re looking for someone with PIO experience (current or within the last 2 years) to sample work done by various areas in the PIO division. This person will be responsible for ensuring work was handled appropriately and according to MTM/LOS and internal guidelines.
Note: This role may require some overtime.
Job Responsibilities
- Disseminating quality information to keep staff informed of guidelines, policies and procedures.
- Proactively identify error trends; recognizing and identifying when procedures need to be changed or developed.
- Maintaining accurate and timely documentation pertaining to individual quality evaluations.
- Participating in defining quality issues and determining approaches and methodology for addressing these issues.
- Work overtime as required
Job Qualifications
Education
- High School Diploma or equivalent
Experience
- 1 year - Applicable system experience (Facets, etc.)
- 2 years - Operations experience required
Skills\Certifications
- Must have proficient knowledge in one or more functions being audited
- Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
- Proficient oral and written communication skills
- Proficient interpersonal and organizational skills
- Exceptional time management skills
- Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
- Independent, Sound decision-making and problem-solving skills
- Capacity to solve problems and manage multiple assignments with critical deadlines
- Capability to handle large volumes of work
- If current employee with the company, must meet minimum performance expectations
- Current or previous PIO experience preferred.
Number of Openings Available:
1
Worker Type:
Employee
Company:
BCBST BlueCross BlueShield of Tennessee, Inc.
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
Tobacco-Free Hiring Statement
To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.
Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.
