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:

We are seeking a meticulous and experienced Quality Assurance (QA) Auditor to join our team. The QA Auditor is responsible for ensuring the integrity and accuracy of patient information within Health Information Technology (HIT) systems. The QA Auditor will navigate various health plan Electronic Medical Records (EMRs) to maintain high standards of quality assurance, and ensure compliance with industry standards and regulations.

EDUCATION AND EXPERIENCE:

• High school diploma or GED required; Bachelor’s in a related field preferred.
• Minimum 1 year of experience in quality assurance or a healthcare role required.

REQUIRED SKILLS/ABILITIES:

• Proficiency in Microsoft Office Suite and quality management software.
• Effective and professional communication skills, both written and verbal.
• Excellent analytical and problem-solving skills.
• Strong attention to detail and organizational skills.
• Bilingual in Spanish preferred.

PHYSICAL REQUIREMENTS:

• Prolonged periods of sitting at an office desk on the computer.
• Lifting: Able to lift up to 15lbs at times.

• Identify, assess, correct, and monitor critical aspects of patient data while adhering to strict guidelines set by the Department of Health Care Services (DHCS) and Health Care Providers.
• Understand and apply practices and procedures established by DHCS and Providers.
• Navigate and work proficiently with multiple health plan EMR systems.
• Collaborate with various departments to ensure quality standards are met throughout the production process.
• Monitor and identify key errors within patient information.
• Prepare detailed audit reports and present findings to management.
• Comply with organizational guidelines and health care laws and regulations, including HIPAA.
• Perform additional duties as assigned.