Clinical Quality Assurance Coordinator – Supervisor

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Supervise the daily operations of the Quality Assurance Department, providing leadership and guidance to ensure that processes function as efficiently and effectively as possible.

• Coordinate and manage the QA department's daily tasks to guarantee that all product lines are completed with the utmost quality in the most effective and efficient manner.

• Prioritize and oversee the daily workload, ensuring that work is distributed fairly and appropriately to meet objectives.

• Monitor outputs to ensure that clear, concise, evidence-based rationales are provided for all recommendations or decisions, and that specific indicators and criteria in line with company policies and procedures are met.

• Ensure that the department complies with all federal ERISA and state regulations at all times.

• Encourage the effective and efficient use of all clinical resources and make necessary improvement recommendations to management as needed.

• Maintain all client relationships and ensure that specific client requirements are fulfilled.

• Promptly assist in resolving any physician or customer complaints, as well as quality assurance issues.

• Delegate tasks as needed and provide support to all departmental positions when required.

• Offer insights and guidance to management regarding consultant quality, availability, and compliance with all company policies and procedures.

• Engage in the development and implementation of policies and procedures to promote and achieve the most efficient operations possible.

• Participate in various educational and training activities as required.

• Carry out other assigned duties.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of three years of relevant experience or an equivalent combination of education and experience is preferred.

• Familiarity with the insurance industry, particularly claims management related to workers' compensation, no-fault, liability, and disability, is preferred.

• Previous supervisory experience is preferred.

• Must have a working knowledge of the medical legal aspects of medical records and health information principles and/or liability.

• Must possess comprehensive knowledge of general office equipment, including computers, fax machines, copiers, scanners, and telephones.

• Proficiency in various software programs, including but not limited to Microsoft Word, Excel, and the Internet, is required.

• Must be a qualified typist with a minimum speed of 40 words per minute.

• Exceptional communication skills are essential.

• Ability to analyze problems involving multiple interrelated causes.

• Gathers information and applies complex concepts or methods to create effective solutions.

• Ability to follow instructions and accurately respond to upper management’s directives.

• Must demonstrate precision, thoroughness, and accountability for the quality of work, along with the initiative to identify areas for improvement.

• Seeks opportunities to enhance quality and monitors personal work to ensure standards are met.

• Must be able to work independently, prioritize tasks, and utilize time efficiently.

• Capable of taking independent actions and calculated risks when necessary.

• Must exercise good judgment and involve the appropriate individuals in the decision-making process.

• Must maintain confidentiality.

• Must demonstrate and foster a positive team-oriented environment.

• Must maintain focus and concentration amidst normal or significant distractions.

• Must be able to perform well under pressure and in stressful situations.

• Must possess the ability to manage and direct change, delays, or unexpected events appropriately.

• Ability to adhere to all company policies and procedures in effect at the time of hire and as they may evolve or be introduced over time.

🏝️ Benefits

• Competitive benefits package (medical, vision, dental).

• Paid time off.

• 401k plan.