Manager, Quality Assurance Business Analytics_OPS

Manager, Quality Assurance Business Analytics

Manager, Quality Assurance Business Analytics

Who are we?

Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.

As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.

See how you can make a difference with the support of strong leadership and a team environment.

See Everything, Be Anything™.

What are we looking for?

The Quality Assurance, Business Analytics Manager is responsible for facilitating to completion all compliance audits and findings for each functional area within the department. Additionally, this role monitors and evaluates, according to department. standards, the quality of work performed in Membership, Billing and Claims and recommends process improvement solutions for both the quality and timeliness of work performed in the department. Also, ensures quality and regulatory goals and

deadlines are met or exceeded.

Where you will have an impact

• Lead the Quality Assurance team to include selection, training and development, coaching, counseling and performance management
• Manage, track, trend and create a library of all issues, along with resolutions, for cases which are presented to the department from Corporate Compliance
• Develop and maintain a quality assurance program which monitors and reports the quality of performance in each functional area within the department
• Partner with other department managers to create a quality manual which documents staff expectations and corrective actions when metrics are not satisfied
• Lead the evaluation and rating of work performed in each functional area
• Propose solutions to any defects or quality improvements identified during compliance or quality audit reviews
• Provide statistical reporting and analysis of results from quality and compliance performance
• Provide client service and technical support, including data analysis, troubleshooting and issue resolution
• Assist in and developing enhancements to the Claims, Billing and Enrollment processes and workflows to improve efficiency, accuracy, and delivery
• Direct and monitor all work activities performed by the Department’s Business Analysts to ensure that their support enhances the quality and timeliness of work performed by the Department
• Work as part of a team environment to ensure expectations are met for both internal and external customers
• Conform with and abide by all federal, state, and local regulations, company policies and procedures, and instructions
• Adhere to privacy, confidentiality, and proprietary company policies and procedures (i.e. HIPAA)
• Perform additional duties as assigned by management

 What’s necessary to do the job?

• Preferred Bachelor's degree in related field or equivalent combination of experience and education
• Minimum One (1) years of related experience to include quality assurance and audit, managing teams, setting goals/expectations, timeline driven outcomes, and implementation of sustainable strategic solutions
• Thorough knowledge of health insurance demonstrated and health plan experience as might be shown by a minimum of three (3) years of experience at an insurance company.
• Direct client interface experience
• Proficient in Microsoft Office

HIPAA & Security Requirements

All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

The wage range for applicants for this position is [$83,000.00 to $88,000.00].

All incentives and benefits are subject to the applicable plan terms.