Quality Assurance Manager - Payer Risk Adjustment and Quality Analytics (HEDIS)

Allscripts; Dallas (TX); On-site; USD 100,000 - 130,000; Full time

Job summary

A leading company in healthcare technology is seeking a Quality Assurance Manager to lead a QA team focused on payer analytics solutions. The ideal candidate will have extensive experience in quality assurance and a strong understanding of healthcare metrics like HEDIS. This role involves defining QA strategies, mentoring team members, and ensuring compliance with quality standards.

Benefits

Comprehensive compensation and benefits package

Medical, dental, and vision insurance

Company paid life insurance

Retirement savings plan

Qualifications

• 10+ years of Quality Assurance experience from a technology company.
• 5+ years leading QA/Development teams in healthcare technology.
• Strong understanding of HEDIS and STAR Ratings.

Responsibilities

• Define and deliver QA strategy with a focus on automation.
• Ensure test cases are documented and functionality is ready for release.
• Work collaboratively with development and operations teams.

Skills

Quality Assurance

Leadership

Communication

Teamwork

Education

Bachelor’s degree in computer science or related field

Job description

Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.

Veradigm understands that managed care organizations, pharmacy benefit managers (PBMs), insurance companies, health plans, and other payers need to balance controlling costs with the goal of providing the highest quality of care and optimizing health outcomes for their members.

Solutions from Veradigm Payers :

• Deliver insights to drive quality outcomes cost-effectively
• Improve efficiency for themselves, their providers, and their members through high-speed clinical data exchange
• Impact point-of-care decision making positively by integrating payer guidance and prior authorization management directly in each healthcare provider’s existing workflow

Job Summary :

Quality Assurance Manager – Payer Risk Adjustment & Quality Analytics (HEDIS)

The Development Manager will lead and manage a Quality Assurance team across our Payer Analytics solutions. The Manager will be responsible for defining QA strategy with a special focus on automation, leading and auditing quality assurance initiatives, managing the team and estimating workload, providing high level guidance, and working with development and product management teams to communicate development and release information thoroughly and accurately.

What you will contribute :

• Define and deliver QA strategy with a special focus on automation
• Develop and refine Quality Assurance standard operating procedures incorporating industry best practices
• Provide high level guidance and technical mentorship to team members.
• Ensure test cases are documented appropriately for user stories and conducted in full prior to deeming the functionality is ready for release
• Work with business analysts to define, break down, prepare and estimate features and user stories for the sprint team.
• Ensure all quality, security and compliance processes are followed.
• Work with the team to meet quality assurance testing milestones.
• Work collaboratively with the support, operations, development and information systems team to ensure the system is running efficiently and effectively (timely and accurate)
• Work closely with the operations and technology teams ensuring hand-offs and dependencies are understood and maintained
• Ensuring commitments and progress to schedules remain clear, reasonable, and proactively monitored
• Provide regular constructive feedback on performance / development and address subpar performance in a timely manner
• Recognize high performers to maintain motivation and retain key talent
• Ownership of end-to-end process improvement efforts as appropriate to project and product need
• Regular use / reporting of metrics for resource allocation, software defects, productivity, and efficiency
• Participation in and implementation of established global software quality improvement initiatives and processes, adherence to standards, and timely, measurable results
• Define, develop and monitor key metric reports to ensure technology is working optimally for customers

The ideal candidate will have :

Academic and professional qualifications :

• Bachelor’s degree in computer science or related field or equivalent technical / business experience required

Experience :

• 10+ years of Quality Assurance experience from a technology company
• 5+ years of experience leading Quality Assurance / Development teams in a high growth healthcare technology company
• Strong understanding of payer subject matter including HEDIS and STAR Ratings quality measures reporting, and risk adjustment
• Excellent communication skills and ability to interface with both external and internal personnel at all levels
• Ability to work within a team environment

Travel Requirements :

• Less than 10% travel for internal meetings and / or client engagements

Compliance Job responsibilities include fostering the Company’s compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyone’s responsibility. #LI-Remote#LI-KB1

Enhancing Lives and Building Careers

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We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

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Quality Assurance Manager • Dallas, Texas, United States