Temporary Quality Assurance Coordinator- Complaints Unit & Fair Hearings (Remote-New York)

Job Introduction

Maximus is currently hiring for a Temporary Quality Assurance Coordinator position! This is a temporary, full time position and is fully remote in the state of New York. 

We are looking for an individual with a great eye for details and exceptional communications skills and an interest in the Quality Assurance field. If you're looking for more than a job and want to make an impact in the healthcare industry, then this is the position for you.

 

 

Job Summary

Essential Duties and Responsibilities:- Responsible for evaluating staff members on the quality of work performed as measured against project standards, contractual requirements and performance measures.- Assist with the development, design and recommend strategies or activities intended to improve performance in Call Center Operations.- Assist with the development, analysis and distribution of project reports and performance indicators.- Regularly assess the knowledge needs of the staff related to processes and policies regarding the client/contract operations and develop plans to meet those requirements.- Conduct monitoring activities for quality assurance purposes.- Assist with monitoring performance and meeting contractual requirements.- Remain up-to-date on policies and procedures for all operations, assists in developing new procedures, and updates existing procedures when changes occur.- Assist in the production and update of staff resource materials including quick reference guide, matrices, charts, and workflows.- Assist with staff training, as necessary.- Meet all standards established for this position as outlined in the attached performance criteria.- Perform other duties as may be assigned by corporate management.Minimum Requirements:- High School diploma or equivalent with 0-2 years of experience.- May have additional training or education in area of specialization.- Work on assignments that are routine in nature, with responsibilities easily learned on the job.- Acquire job skills and learns applicable policies and procedures to complete routine tasks.- Able to read, understand & perform assignments within prescribed guidelines.- Communicate routine information in a clear and accurate way with internal & external contacts.

Education and Experience Requirements

Essential Duties and Responsibilities:

 

• Responsible for evaluating staff members on the quality of work performed as measured against project, standards, contractual requirements and performance measures


• Assist with the development, design, training and strategies or activities intended to improve performance in Call Center Operations


• Assist with the development, analysis and distribution of project reports and performance indicators


• Regularly assess the knowledge needs of the staff related to processes and policies regarding the client/contract operations and develop plans to meet those requirements


• Remain up-to-date on policies and procedures for all operations, assists in developing new procedures, and updates existing procedures when changes occur


• Assist in the production and update of staff resource materials including quick reference guide, matrices, charts, and workflows


• Represent the New York Independant Assessor Program (NYIA) in Fair Hearings before Administrative Law Judges for disputed decision


• Compile Fair Hearing evidence packages (case files) and handle appropriately (distribute, log, file, etc.)


• Communicate information on Fair Hearing cases directly with state and local agencies, Administrate Law Judges, Plan’s legal representatives, consumer’s legal representative and/or advocates


• Develop Fair Hearing conclusion reports using case notes, hearing information, etc. and present to project management and the client

 

Minimum Requirements:

• High School diploma or equivalent with 0-2 years of experience working in New York Medicaid Choice programs


• May have additional training or education in area of specialization


• Work on assignments that are routine in nature, with responsibilities easily learned on the job


• Able to read, understand & perform assignments within prescribed guidelines


• Communicate routine information in a clear and accurate way with internal & external contacts


• Must be knowledgeable about New York Independant Assessor (NYIA) program policies and procedures, program objectives and enrollment processes


• Capable of presenting at formal case hearings, researching and investigating root causes, and gathering and reporting programmatic data


• Must have strong analytical skills with the ability to successfully handle multiple tasks; 


• Proficiency in Microsoft Word, Excel, and other computer software applications


• Excellent organizational, interpersonal, written and verbal communication skills


• Ability to perform comfortably in a fast-paced, deadline-oriented team and independent work environment


• Willingness to travel throughout NY State

 

Home Office Requirements:

• Maximus provides company-issued computer equipment


• Reliable high-speed internet service


• Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity 


• Minimum 5 Mpbs upload speeds

 

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MAXIMUS Introduction

Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com.

EEO Statement

EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies MAXIMUS deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. MAXIMUS is an Affirmative Action/Equal Opportunity Employer. MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation shall be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation.

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