Quality Auditor Jobs

JOB DESCRIPTION
JOB SUMMARY:
Responsible for performing quality reviews on iServe fulfilled tickets processed by the PCM Maintenance teams for adherence to documented business guidelines. Validate all IQA forms are followed up on accurately and timely based on documented business rules. Ensure all sanctioned providers are updated accurately and timely to meet compliance adherence thresholds. Monitor the Daily Discrepancy Tool (DDT) to ensure all identified fallout is updated in provider databases based on business rules. Confirm all contracts are loaded by the PCM Maintenance teams for adherence to documented business rules. Generates weekly quality metric reports to facilitate and support PCM Maintenance configuration efforts. Facilitate quality metrics meetings with PCM business partners. Provide coverage/assistance to quality coach peers as necessary.
KNOWLEDGE, SKILLS & ABILITIES:

• Prepare well organized, easily understood reports, analysis, and summary of findings for use by management
• Works effectively in a team environment and supports the activities and success of others on the team.
• Flexibility to learn and adapt to changes in procedures, techniques, and position requirements.
• Demonstrates flexibility and commitment to complete the tasks and responsibilities of the position when required, including times outside of the position's normal working hours.
• Demonstrates problem solving and analytical skills.
• Develops and maintains knowledge of business policies and procedures, and assesses their impact to applications.
• Performs and accurately completes multiple tasks as required by the position.
• Demonstrates flexibility to learn and adapt to new technologies and standard practices by consistently and appropriately incorporating new processes and procedures as developed and new tools as they are introduced.
• Demonstrates attention to detail.
• Constructively contributes in all team, departmental, project team, status, and other meetings.
• Appropriately uses reference materials and other resources to complete tasks in a timely and effective manner.
• Performs other work as required or requested as well as additional assignments.
• Learns, comprehends, and applies information, both business and technical in a consistently satisfactory manner.

JOB FUNCTION:
REQUIRED EDUCATION:
Bachelor's Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE:
1-3 years
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:
None
PREFERRED EDUCATION:
Bachelor's Degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
1-3 years
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
None
PHYSICAL DEMANDS:
In Office : Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in home or in an office environment. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
Pay Range: $ 54,922 - $107,098 a year*
***Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.***
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.