Quality & Process Improvement Specialist

Benecard Services Inc.•Bonita Springs, FL

1d•Onsite

About The Position

Under the direction of the Quality and Process Improvement (QPI) Manager, the Quality and Process Improvement (QPI) Specialist will have cross-functional responsibilities that include reviewing documents for spelling, grammar, and accuracy. Reviewing member card ID packets, claims, clinical reviews, and other various aspects of the system on a day-to-day basis. This is a 5 day in-office direct hire opportunity located in Bonita Springs, Florida.

Requirements

High School Diploma or equivalent is required
Microsoft Office Suite knowledge
Proficiency presentation of data analyses (trending data and articulate / breakdown analysis)
Must have exceptional interpersonal and organizational skills
Must be detail-oriented
Must have professional written and verbal communication skills
Must demonstrate flexibility and ability to work in high pressure situations and conform to tight deadlines

Nice To Haves

Knowledge of Cognos Business software is preferred
Medical and/or pharmaceutical background is highly desirable
Prior Quality Management background is highly desired

Responsibilities

Completing quality reviews on documents, claims, and clinical reviews
Contribute, monitor, and report on the success of key tactical strategies
This position will interact with all levels of management and departments
Detailed analysis and summary reporting
Develop and maintain various analysis and reporting tools
Utilize COGNOS reporting software to query routine and ad hoc monitoring reports
Develop and maintain various Policies, Desktop Procedures, Process Flows, Frameworks, and Dashboards
Facilitate regular meetings with Business Owners and Management staff of various departments to identify quality concerns and coordinate improvement efforts
Identify and investigate issues with a focus on root cause analysis and proposed resolutions
Complete special quality-related projects in short timeframes with a high level of accuracy
Provide additional resource support to all areas within the QMIG department and may also provide resource support to other operational areas as needed
Other duties as assigned