Quality Assurance Analyst - HRSN

CareOregon•Portland, OR

1d•$66,690 - $81,510•Hybrid

About The Position

This position is responsible for providing timely and accurate quality assurance, administrative, and analytical support for CareOregon’s internal Rent Assistance team and the Health-Related Social Needs (HRSN) benefit. The role ensures that member benefit allocations and payments are accurate, timely, and compliant with applicable regulatory, contractual, and organizational requirements. This is a hybrid position with the expectation to come to the downtown Portland office 1x/week. We are looking for candidates located in Portland Metro.

Requirements

Minimum 2 years’ experience in data quality assurance to include data entry, tracking, and reporting
Minimum 4 years’ experience in Medicaid, health plan operations, or managed care organizations
Experience with regulation and applying rules to a process
Knowledge working knowledge of Microsoft Office system, including intermediate Excel skills
Knowledge of basic medical terminology
Knowledge of care management platforms and experience with documenting in care management or similar platform
Knowledge and experience with Federal, State and Local regulations and HIPAA privacy rules and regulations
Strong organizational skills
Attention to detail
Familiarity with Medicaid claims billing and coding
Computer skills and ability to learn new technology quickly
Ability to use good judgment, personal initiative and discretion to perform work with particular attention to detail
Ability to effectively interact with individuals at all levels internal and external to the organization
Good written and verbal communication skills
Good customer service skills
Basic teamwork skills
Ability to manage multiple tasks
Ability to work in a fast-paced environment
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
Ability to hear and speak clearly for at least 3-6 hours/day

Nice To Haves

Experience in managed care
Experience in quality assurance or improvement
Experience collaborating on or managing projects
Housing familiarity

Responsibilities

Conduct timely and accurate quality assurance reviews of member benefit allocations prior to payment, ensuring alignment with state and federal regulations and CareOregon policies.
Review supporting documentation and system data to validate eligibility, benefit limits, accuracy of calculations, and appropriateness of payment amounts.
Identify trends, patterns, and root causes of errors; proactively recommend corrective actions to improve quality, consistency, and productivity.
Research claim, invoice, enrollment, and benefit processing issues to determine source, contributing factors, and appropriate resolution, escalating issues as needed.
Collaborate with the Rent Assistance team to reduce rework by clarifying requirements, identifying gaps in documentation, and recommending process or workflow improvements.
Develop, maintain, and distribute summary-level, quality assurance, and performance reports for leadership and the Oregon Health Authority (OHA).
Analyze data and quality review results to identify improvement opportunities, compliance risks, and training needs.
Track corrective actions and outcomes to assess effectiveness of improvement efforts over time.
Support audits, inquiries, and data requests by preparing accurate documentation and responsive analyses.
Support the development and delivery of training materials, job aids, and guidance to proactively address quality trends, common errors, and policy updates.
Partner with management and cross-functional teams to ensure quality assurance reviews remain effective, relevant, and aligned with organizational needs.
Participate in meetings and workgroups related to HRSN benefits, rent assistance operations, and quality improvement initiatives.
Perform accurate and timely data entry and accounting-related support, including reviewing invoices, ledgers, rental statements, and utility bills to determine eligible reimbursement or payment amounts in accordance with benefit policies and procedures.
Ensure all documentation is complete, properly stored, and accessible for reporting, audit, and compliance purposes.
Utilize technology systems and databases effectively for documentation, quality tracking, reporting, and communication.
Use standard Microsoft Office applications (Excel, Word, PowerPoint, Outlook), SharePoint, Workday, Unite Us, and other applicable systems to create and maintain documents, spreadsheets, charts, graphs, and reports.
Independently manage special projects or ad hoc assignments as assigned, including process reviews, data clean-up efforts, and pilot initiatives.
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.

Benefits

Competitive pay
Bonus opportunity
Medical insurance
Dental insurance
Vision insurance
Life insurance
AD&D insurance
Disability insurance
Health savings account
Flexible spending account(s)
Lifestyle spending account
Employee assistance program
Wellness program
Discounts
Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
Strong retirement plan with employer contributions
Accrued PTO
Paid State Sick Time
Paid holidays
Volunteer time
Jury duty
Bereavement leave
401(k) contributions (for non-benefits eligible employees)
Perks