Quality Assurance Manager

Provider Resources, Inc.; Erie (Erie County); On-site; USD 95,000 - 140,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401k plan

Paid Time Off

Job summary

Provider Resources, Inc. (PRI) seeks a QA Manager to lead the IDRE quality assurance program, guiding QA Analysts and Leads while ensuring CMS and URAC standards compliance.

You will own the sampling program, analyze QA data, and drive corrective actions in collaboration with Operations and Training. Ideal candidates have 7–10 years in QA/compliance with 3+ years of supervisory experience, strong communication skills, and a track record of delivering projects to completion.

Qualifications

• 7 to 10 years QA or compliance review including 3+ years managing a QA team.
• Team leadership experience with 10+ member teams.
• Knowledge of the No Surprises Act, IDRE quality requirements and URAC standards.
• QA sampling program design experience.
• Experience developing or executing an inter-rater reliability program.
• Exceptional verbal and written communication skills.
• Critical thinking and problem-solving capability.
• Demonstrated history of driving projects to completion.
• Strong analytical skills.
• ISO 9001 or equivalent a plus.

Responsibilities

• Lead and develop QA Analysts and QA Leads.
• Manage operational cadence with the team, including daily productivity, meetings, and training.
• Own the IDRE QA sampling program - methodology, frequency, and scope.
• Analyze QA data and provide insights to Operations, Training, and other PRI leaders.
• Monitor QA error trends and support Operations and Training to take corrective action.
• Build an inter-rater reliability program to ensure accuracy and consistency.
• Maintain all QA program documentation and ensure it meets CMS and URAC standards.
• Represent QA in meetings with internal stakeholders and be a thought partner for program improvements.
• Prepare QA reports for leadership.

Skills

QA leadership

Data analysis

Communication skills

Problem solving

Project management

Education

ISO 9001 knowledge

Job description

PRI is looking for a QA Manager to lead our IDRE quality assurance program. This is a management role for an experienced QA professional with healthcare or IDRE quality experience.

What you will do:

• Lead and develop QA Analysts and QA Leads
• Manage operational cadence with the team, including daily productivity, meetings, and training
• Own the IDRE QA sampling program - methodology, frequency, and scope
• Analyze QA data and provide insights to Operations, Training, and other PRI leaders
• Monitor QA error trends and support Operations and Training to take corrective action
• Build a comprehensive inter-rater reliability program to ensure accuracy and consistency
• Maintain all QA program documentation and ensure it meets CMS and URAC standards
• Represent QA in meetings with internal stakeholders and be a thought partner for overall program improvement
• Prepare QA reports for leadership

What we are looking for:

• 7 to 10 years QA or compliance review including 3+ years managing a QA team
• Team leadership experience with 10+ member teams
• Knowledge of the No Surprises Act, IDRE quality requirements and URAC standards
• QA sampling program design experience
• Experience developing or executing an inter-rater reliability program
• Exceptional verbal and written communication skills
• Critical thinking and problem-solving capability
• Demonstrated history of driving projects to completion
• Strong analytical skills
• ISO 9001 or equivalent a plus

As an EEO/Affirmative Action Employer all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status.

Benefits and Compensation Provider Resources provides a competitive benefits package that includes access to Medical, Dental, and Vision Insurance, Life Insurance, Disability, Health Savings Account (HSA), Flexible Spending Accounts (FSA), Critical Illness, Accident, Legal and ID Theft, 401k plan, PTO. The anticipated salary range for fully qualified candidates applying for this role will be above (not including discretionary bonus, equity, and benefits). The final salary offered will be dependent on several factors that include but are not limited to relevant previous experience including duration and type of experience within the industry, education, and internal equity.