Clinical Quality Support Specialist

TriWest Healthcare Alliance Corp.; Phoenix (AZ); Remote; USD 38,000 - 45,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan (with 0

Job summary

TriWest Healthcare Alliance is seeking a non-clinical administrative support specialist to assist the Clinical Quality Department. You will manage incoming and outgoing correspondence, prepare documents, and compile data for PQI reviews and focused studies.

Responsibilities include distributing materials for quality meetings, maintaining department files, processing invoices, and supporting credentialing committees. A DoD background and US citizenship are required for this DoD contract.

Qualifications

• High School diploma or GED.
• 3+ years of administrative experience.
• Experience in a medical office, health insurance, or managed care.
• Proficient with Microsoft Excel, Word, and Outlook.
• Ability to work in multiple software programs.

Responsibilities

• Manage incoming/outgoing correspondence and documents for the department.
• Prepare materials for PQI reviews and meetings/workgroups.
• Track follow-ups to obtain requested documents for PQI review or focused studies.
• Maintain CQM department files to meet TriWest confidentiality and security requirements.
• Process invoices for medical records and coordinate with Finance/Accounting.
• Process incoming/outgoing mail and faxes and support department mailing needs.
• Participate in department meetings and workgroups, supporting quality improvement efforts.

Skills

Multi-software proficiency

Time management

Communication skills

Education

High School Diploma or GED

Associates Degree in Business or Administrative Services

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

• Microsoft OneNote experience

Profile

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

This position works under the direction of the Manager, Clinical Quality to provide non-clinical support for the Clinical Quality Department. Manages incoming and outgoing correspondence. Prepares documents and compiles data for meetings and workgroups. Tracks and conducts follow up to obtain requested documents for PQI review or focused studies.

Education & Experience

Required

• High School Graduate or G.E.D.
• 3+ years administrative experience or equivalent
• Experience in a medical office, health insurance, or managed care organization
• Proficient with Microsoft Excel, Word, Outlook
• Ability to work in a multiple software programs

Preferred

• Associates Degree in Business or Administrative Services
• Medical terminology
• Microsoft OneNote experience
• Letter writing Experience

Key Responsibilities

• Orders/receives medical records for Potential Quality Issues (PQI and CQM Department activities according to desk procedures, conducts follow-up telephone calls to providers, and completes other processes to resolve missing documents.
• Obtains, prepares and distributes materials for quality meetings. Workgroups and projects as directed.
• Maintains all CQM department files to meet TriWest confidentiality and security requirements.
• Processes invoices for medical records received. Follows up, as needed, with the Finance/Accounting Dept.
• Processes incoming and outgoing mail and faxes, correspondence for overnight or certified delivery, and other mailing needs.
• Participates in department meetings and work groups, serving on quality improvement committees as needed.
• Performs other duties as assigned.
• Regular and reliable attendance is required.
• Supports department activities for Provider Credentialing Committee.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Working knowledge of functional TriWest departments and locations. Ability to work with sensitive and confidential information in the appropriate manner. Proficient at Excel, PowerPoint, and Word.

Working Conditions

• Works in a standard office environment, with no travel
• Extensive computer work with prolonged sitting
• May require occasional evening meeting attendance

Company Overview

Taking Care of Our Nation’s Heroes.

It’s Who We Are. It’s What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve!

Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $38,000 - $45,000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.