QA analyst PEC - Great Location

Location: Boston
Posted on: October 29, 2024

Job Description:

This QA Analyst PEC Position Features:

? Great Location

? Professional Environment

? Room For Growth

Immediate need for qa analyst pec seeking great location, professional environment and room for growth. Responsible for validating the quality of Provider Enrollment and Credentialing (PEC) activities including review of PEC applications and data entry. Conducts quality control (QC) activities throughout the PEC process. Works closely with PEC Specialists to ensure that provider applications are processed timely and correctly in compliance with SLAs. Provides assessment and trend reports to management. Must be extremely detail oriented and knowledgeable on MS Office.

Ensures activities and processes are in compliance with both company QA standards, regulations and applicable contractual standards.

Conducts QC activities related to application processing and data entry functions.

Reviews each application for: compliance with regulations; completeness, accuracy of information; validates documentation including licensure; validates that data entry is complete, accurate, and compliant with EOHHS regulations.

Identifies errors with applications and data entry and ensures timely correction.

Performs analysis and identifies trends in the inspection of provider applications, provider files, and data entry of applications.

Identifies areas for Continuous Quality Improvement (CQI) throughout PEC processes.

Ensures that established service inspection, sampling and statistical process control procedures are followed.

Trains staff for the purpose of achieving or maintaining quality assurance goals.

Effectively communicates with all facets of project to further quality assurance goals.

Develops routine and ad-hoc reports.

Performs other duties as may be assigned by management

Education and Experience:

Bachelor Degree from an accredited college or university.

Experience with the MassHealth program provider services.

Knowledge of PEC policies and procedures, knowledge of EOHHS regulations and program highlights.

3 - 5 years experience working with MassHealth provider credentialing.

3 - 5 years of quality experience; experience with TQM, ISO, Six Sigma, or other quality management techniques and tools.

Excellent written and verbal communication skills.

Ability to perform comfortably in a fast-paced, deadline and detailed-oriented work environment.

Ability to successfully execute many complex tasks simultaneously.

Ability to work both as a team member as well as independently.

Significant time spent working at a computer terminal.

Apply for this great position as a qa analyst pec today! We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

Keywords: , Nantucket , QA analyst PEC - Great Location, Professions , Boston, Massachusetts