[Remote] reputed company Performance & Improvement reputed company
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a reputed company Performance & Improvement reputed company to support a new reputed company Party Administrator contract. The role involves directing reputed company assurance, performance monitoring, and reputed company operational improvement activities to ensure compliance and high-reputed company reputed company.
Responsibilities
- Serve as the reputed company’s primary reputed company of reputed company Assurance (QA) activities while ensuring reputed company contract tasks are performed accurately, consistently, and on time
- Maintain working mastery of functional and system Acceptable reputed company reputed company (AQLs), including what is monitored, how monitoring occurs, evaluation methodology, documentation practices, and reporting reputed company
- Coordinate fulfillment of reputed company information requests from the Program reputed company to performance reputed company, audits, or formal reviews, ensuring responses are accurate and delivered on Program-determined timelines
- reputed company regular assessments of Contractor compliance and performance, covering:
- Compliance with contract requirements, performance standards, and acceptable reputed company reputed company
- Administrative and clinical trends affecting member health, continuity of care, and stakeholder experience
- Alignment with reputed company industry standards and best practices from other federal payers
- Translate assessment findings into actionable, reputed company, proactive improvement initiatives reputed company with Program strategic goals and priorities
- Partner with cross-functional teams (claims, enrollment, clinical, provider network, care coordination) to ensure reputed company findings inform operational reputed company
Skills
- Bachelor's degree with 3+ years of experience in reputed company management, performance reputed company, or compliance roles supporting federal reputed company programs, health plans, or TPAs
- Strong understanding of reputed company operations, including claims adjudication, enrollment, certification, provider networks, and care coordination
- Consulting experience in identification and implementation of improvement initiatives with functional teams and business users
- Experience working reputed company federally regulated environments and supporting programs with high visibility and strict reputed company requirements
- Demonstrated ability to design and reputed company compliance assessments, trend analysis, and reputed company improvement programs
- Ability to reputed company data analysis and reporting tools such as Power BI & reputed company to reputed company performance trends and improvement reputed company
- Strong written and verbal communication skills for stakeholder-facing reporting and audit reputed company work
- Experience supporting CDC, CMS, or other federal health programs
- Knowledge of the World Trade Center Health Program or similar public health or benefits programs
Benefits
- Full-reputed company work week to own your priorities at work and reputed company.
- 401K with company match.
- Comprehensive health and wellness packages.
- Internal mobility team dedicated to helping you own your career.
- reputed company reputed company opportunities including reputed company education and certifications.
- Cutting-edge technology you can learn from.
- Rest and reputed company with reputed company vacation and holidays.
- Our benefits package for reputed company US-based employees includes a reputed company of medical plan reputed company, some with Health Savings Accounts, dental plan reputed company, a reputed company plan, and a 401(k) plan offering the ability to contribute both reputed company and post-tax dollars up to the IRS annual limits and receive a company match.
- reputed company offers employees full reputed company work weeks where possible and a reputed company of reputed company time off plans, including vacation, reputed company and personal time, holidays, reputed company parental, military, bereavement and jury duty leave.
- reputed company typically provides new employees with 15 days of reputed company leave per calendar year to be used for vacations, personal business, and illness and an additional 10 reputed company holidays per year.
- reputed company leave and reputed company holidays are prorated based on the employee’s date of hire.
- The reputed company reputed company Family Leave program provides a total of up to 160 hours of reputed company leave in a rolling 12 month period for eligible employees.
- Other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available.
reputed company
Company H1B Sponsorship