Healthcare Quality Assurance Lead at Serene Health

Goodyear, Arizona, United States -

Full Time

Start Date

Immediate

Expiry Date

21 May, 26

Salary

26.0

Posted On

20 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Teamwork, Collaboration, Innovation, Training Coordination, Auditing, Productivity Improvement, Reimbursement Review, Program Evaluation, Adaptability, Team Leadership, Organizational Skills, Attention To Detail, Time Management, Communication Skills, Interpersonal Skills, Medical Terminology

Industry

Hospitals and Health Care

Description

Empowering Wellness, Transforming Lives Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being. As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities. Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members. A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work! Job Summary: The official job title is Lead QA Auditor. The Lead QA Auditor supports QA Management. The Lead QA Auditor oversees workflows within the CS Quality Assurance Department. The Lead QA Auditor will work to communicate updates/changes and policies within the department. This role is to reinforce the standards set forth by QA management. It requires the ability to further ensure teamwork, collaboration, and innovation. Job Duties: Coordinate workflows and communication for administered in-house training sessions. Support special projects and request audits for the executive, billing and QA team. As needed, collaborates in care management workflows in health plan databases and Alliance portal to review documentation and improve productivity and reimbursements. Actively participates in program performance improvement and evaluation initiatives. Ability to adapt to workflow changes and special projects based on organizational needs and requirements. Facilitates a team approach within the department while overseeing the current auditors on staff. Perform other duties as assigned to support the success and effectiveness of the Training and Development team. Requirements: Ability to collaborate effectively with team members. Ability to work well in both a team-based environment and independently. Basic computer literacy ability to comply with department needs and expectations (i.e., electronic medical record documentation, obtaining background information and reports on patients, following up on appointments, etc.). Demonstrated ability to be culturally sensitive and respect diversity. Excellent organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals. At least six months of experience in healthcare quality assurance or similar. Demonstrated team leader skills. Ability to multi-task and prioritize as needed. Ability to independently seek out resources and work collaboratively Must be able to work in an interdisciplinary team setting. Effective communication and interpersonal skills. Prolonged periods of sitting at a desk and working on a computer. Quality Management & Record Keeping Contribute to the success of the organization by participating in quality improvement activities. Document as necessary in required Electronic Medical Record portals and Managed Care Plan portals for all care coordination and other services or teaching provided in a timely Prioritizes duties according to intensity, need, and required follow-up. Work independently or as part of a team and follow through on assignments with minimal supervision. Skills & Competencies Possesses excellent writing and strong presentation skills. Must be able to read and interpret data, information, and documents. Ability to complete assignments with attention to detail and high degree of accuracy. Proven ability to perform effectively in a demanding environment with changing workloads and deadlines. Work and communicate effectively with staff and management. Work effectively under stress and conflict. Exercise appropriate judgment and decision making. Be well organized, flexible, and self-disciplined. Knowledge of medical terminology. Proficient in Microsoft Office suite, including familiarity with spreadsheets, databases, scanning, printing, and faxing. Effective communication and organizational skills. Physical Requirements: Prolonged periods of sitting at an office desk on the computer. Lifting: Able to lift up to 15lbs at times. Pay range $24—$26 USD Benefits Our full-time employees are eligible for the following benefits enrollment after 60 days of employment: Medical, Dental, & Vision Benefits: We have various insurance options for you and your family. Short & Long-Term Disability Benefits: Protection when you need it most. Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones. Flexible Spending Accounts: Manage your finances with flexibility. Employee Assistance Program (EAP): Support when life throws challenges your way. 401(K): Building your financial future with us. Effective after 1 year of employment. Paid Vacation and Sick Leave: Flexibility for the planned and unplanned. Paid Holidays: Quality time to enjoy celebrations. Employee Referral Program: Share the opportunities and reap the rewards. Company Discount Program: Enjoy savings on everyday expenses and memberships. Equal Employment Opportunity Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities. Pre-Employment Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.

Responsibilities

The Lead QA Auditor supports QA Management by overseeing workflows within the CS Quality Assurance Department, communicating updates, and reinforcing established standards. This role involves coordinating training sessions, supporting special projects, reviewing documentation for productivity and reimbursements, and facilitating a team approach among current auditors.