What are the responsibilities and job description for the Workforce Operations Manager position at Gainwell Technologies?
Job Summary
HMS is a leader in the healthcare industry, dedicated to making the system work better for everyone. We are seeking a highly skilled and detail-oriented Workforce QA Manager to oversee vendor operations, workforce management, quality assurance functions, and training initiatives. This role is responsible for ensuring optimal vendor performance, managing inventory and reporting processes, monitoring key performance indicators (KPIs), and implementing quality control measures to enhance productivity and revenue performance.
About HMS
HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare-now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives.
Responsibilities
This position involves overseeing vendor operations, ensuring alignment with organizational goals and contractual obligations. The candidate will manage inventory loads and transfers to meet operational requirements, ensuring accuracy through regular audits. The Workforce QA Manager will maintain accurate records of vendor performance and workforce efficiency, onboard and offboard vendor agents, provide training and guidance as needed, host weekly office hours for vendor agents, communicate changes in carrier, provider, or claims processing guidelines to ensure compliance, and aid in resolving application, system, and technical issues escalated by vendor agents.
Quality Assurance & Performance Monitoring
The successful candidate will conduct regular QA assessments to ensure adherence to company standards and processes. They will establish and oversee quality assurance programs to ensure compliance with industry regulations, identify deficiencies, and recommend actionable solutions to enhance team performance. Additionally, they will develop quality control measures to improve service delivery and operational efficiency, monitor productivity metrics, including quality, efficiency, and revenue generation, to identify areas for improvement, prepare and distribute comprehensive reports on inventory status, workforce productivity, and revenue performance, track and analyze KPIs to measure workforce effectiveness and efficiency, and develop and maintain dashboards and reports using Tableau and other tools to provide real-time insights to leadership.
Leadership Readout & Process Improvement
This role involves facilitating weekly leadership meetings to provide updates on vendor operations, productivity metrics, and revenue performance, presenting findings, recommendations, and action plans to senior management, creating and maintaining detailed documentation of processes, workflows, and reporting methodologies, identifying opportunities for process enhancements, and leading implementation efforts.
Training & Development
The Workforce QA Manager will develop, implement, and oversee a structured training program for new hires to ensure proficiency in company policies, procedures, and job functions, conduct refresher training sessions for existing employees to reinforce best practices and compliance with SOPs, regularly update training materials and SOPs to reflect changes in regulations, company policies, and industry best practices, facilitate workshops and skill-building sessions to enhance employee competencies and operational efficiency, collaborate with leadership to identify skill gaps and create targeted training initiatives to address deficiencies, and maintain training records and evaluate the effectiveness of training programs through assessments and feedback.
Requirements
The ideal candidate will possess a Bachelor's degree in Business Administration, Analytics, Supply Chain Management, Education, or a related field, proven experience in workforce management, quality assurance, vendor coordination, training, and/or performance monitoring, strong analytical skills with experience in data-driven decision-making, proficiency in SQL, relational databases, Tableau for data visualization and dashboard creation, experience with Tableau, Teradata Studio, Toad, Hyperion (Brio) or similar workforce optimization tools, intermediate proficiency in Microsoft Excel, including pivot tables, VLOOKUP, and basic macros, excellent verbal and written communication skills with the ability to interact effectively with stakeholders at all levels, strong organizational skills, attention to detail, and ability to multitask in a fast-paced environment, and experience in developing and facilitating training programs.
HMS is a leader in the healthcare industry, dedicated to making the system work better for everyone. We are seeking a highly skilled and detail-oriented Workforce QA Manager to oversee vendor operations, workforce management, quality assurance functions, and training initiatives. This role is responsible for ensuring optimal vendor performance, managing inventory and reporting processes, monitoring key performance indicators (KPIs), and implementing quality control measures to enhance productivity and revenue performance.
About HMS
HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare-now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives.
Responsibilities
This position involves overseeing vendor operations, ensuring alignment with organizational goals and contractual obligations. The candidate will manage inventory loads and transfers to meet operational requirements, ensuring accuracy through regular audits. The Workforce QA Manager will maintain accurate records of vendor performance and workforce efficiency, onboard and offboard vendor agents, provide training and guidance as needed, host weekly office hours for vendor agents, communicate changes in carrier, provider, or claims processing guidelines to ensure compliance, and aid in resolving application, system, and technical issues escalated by vendor agents.
Quality Assurance & Performance Monitoring
The successful candidate will conduct regular QA assessments to ensure adherence to company standards and processes. They will establish and oversee quality assurance programs to ensure compliance with industry regulations, identify deficiencies, and recommend actionable solutions to enhance team performance. Additionally, they will develop quality control measures to improve service delivery and operational efficiency, monitor productivity metrics, including quality, efficiency, and revenue generation, to identify areas for improvement, prepare and distribute comprehensive reports on inventory status, workforce productivity, and revenue performance, track and analyze KPIs to measure workforce effectiveness and efficiency, and develop and maintain dashboards and reports using Tableau and other tools to provide real-time insights to leadership.
Leadership Readout & Process Improvement
This role involves facilitating weekly leadership meetings to provide updates on vendor operations, productivity metrics, and revenue performance, presenting findings, recommendations, and action plans to senior management, creating and maintaining detailed documentation of processes, workflows, and reporting methodologies, identifying opportunities for process enhancements, and leading implementation efforts.
Training & Development
The Workforce QA Manager will develop, implement, and oversee a structured training program for new hires to ensure proficiency in company policies, procedures, and job functions, conduct refresher training sessions for existing employees to reinforce best practices and compliance with SOPs, regularly update training materials and SOPs to reflect changes in regulations, company policies, and industry best practices, facilitate workshops and skill-building sessions to enhance employee competencies and operational efficiency, collaborate with leadership to identify skill gaps and create targeted training initiatives to address deficiencies, and maintain training records and evaluate the effectiveness of training programs through assessments and feedback.
Requirements
The ideal candidate will possess a Bachelor's degree in Business Administration, Analytics, Supply Chain Management, Education, or a related field, proven experience in workforce management, quality assurance, vendor coordination, training, and/or performance monitoring, strong analytical skills with experience in data-driven decision-making, proficiency in SQL, relational databases, Tableau for data visualization and dashboard creation, experience with Tableau, Teradata Studio, Toad, Hyperion (Brio) or similar workforce optimization tools, intermediate proficiency in Microsoft Excel, including pivot tables, VLOOKUP, and basic macros, excellent verbal and written communication skills with the ability to interact effectively with stakeholders at all levels, strong organizational skills, attention to detail, and ability to multitask in a fast-paced environment, and experience in developing and facilitating training programs.
