What are the responsibilities and job description for the Quality Assurance Manager position at Provider Resources, Inc.?
Quality Assurance Manager
About Provider Resources
At Provider Resources, LLC. (PRI), we are dedicated to strengthening integrity in healthcare through a commitment to health equity, compliance, and quality improvement. Our expert teams collaborate to develop innovative, person-centered solutions that enhance clinical quality, ensure regulatory compliance, and drive meaningful change.
We partner with healthcare organizations, government agencies, and providers to improve health outcomes and create lasting impact. At PRI, you’ll work in a dynamic, inclusive environment where innovation, integrity, and professional growth are valued. Whether you’re passionate about healthcare policy, compliance, or patient-centered solutions, PRI offers opportunities to make a real difference.
Summary
The Quality Assurance (QA) Manager is responsible for leading the QA team in its role of reviewing and improving the quality of work created by various departments within PRI’s Federal No Surprises Act Independent Dispute Resolution Entity (IDRE). The QA Manager supervises a team of QA Analysts and a QA Team Lead as they review a large quantity of decisions by other IDRE teams, provides feedback to those teams, reports on overall quality metrics, and creates systemic improvements to IDRE processes and training to improve quality. The QA Manager develops policies & procedures, coaches QA team members, spearheads special projects, reports up to senior IDRE management, and is responsible for identifying training needs and developing training for the IDRE team.
Duties and Responsibilities
- Manage and develop a team of QA Analysts and QA Team Leads that report directly to the QA Manager. Participate in QA Analyst work as needed to meet the department’s goals.
- Assess and measure team performance, provide feedback, coach, and write reviews.
- Take ownership of Quality Assurance key performance metrics including productivity, quality, accuracy, reporting, and development of policy and training opportunities.
- Help scale the department by assisting with hiring and improving process efficiency to allow the QA team members to increase their productivity.
- Spearhead special projects to investigate quality trends and improve outcomes, both as requested by IDRE leadership and by taking initiative.
- Proactively manage the timeliness and accuracy of reporting from the QA department.
- Interface with members of other IDRE teams to investigate trends, provide feedback, answer questions, and coach personnel. Maintain a professional, collegial, and productive relationship.
- Keep up to date on CMS policies relating to the Federal No Surprises Act IDR process. Understand CMS guidelines and regulations at a high level and proactively learn about changes in policy and changes in stakeholder behavior.
- Keep the QA team aligned with IDRE Senior Management decisions and direction.
- Interact with external stakeholders in the government and private sector in a professional and accountable manner as a representative of PRI management.
- Assist with daily operations across the PRI IDRE team as needed.
- Proactively participate in ISO and Continuous Quality Improvement activities.
- Perform other duties as required.
