REMOTE however if they are remote this person MUST be willing and able to travel to Tampa on a quarterly basis and stay for 3-4 days. And there could be some additional Travel for Growth Sessions as needed
Position Focus
Execute quality checks, operational reporting, level analysis, and workflows including issue classification, coordination, maintaining trackers, peer reviews, and JIRA uploads. Assess errors to determine Level I, II, or III; submit Level III issues in JIRA for resolution.
Reporting Structure:
Reports directly to Quality team.
SQL Skills:
Intermediate: write, manipulate, execute queries, export to Excel.
Excel Skills
Advanced: Pivot Tables, VLOOKUP, table creation.
Reporting Tools
Ticketing systems (JIRA); Tableau not required.
Responsibilities Reporting
Pull, prepare, validate reports; run UAR; evaluate impacted claims; assess errors and submit Level III issues; support operational accuracy.
Collaboration
Collaborate with Service Delivery and internal teams.
Experience Required
Health plan/healthcare services; QA, reporting, denial management, or data validation.
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