Remote Quality Assurance Manager Jobs in Riverside, CA

About Us

All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services toIndependent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. We offer a flexible work environment and schedules with work from home options. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. Additional employee paid coverage options available. We also offer paid holidays, birthday off, and unlimited PTO as well as a 401k plan.

Job purpose

The QA Manager, Reporting & Data Analysis, is responsible for overall quality assurance and testing on reporting and data for clients and is responsible for supporting the Compliance team with reporting and audits. This position oversees data quality, analyzes performance metrics, creates QA reports, and implements strategies to ensure accurate, reliable, and actionable business intelligence. Key duties include defining data standards, managing testing tools, and collaborating with teams to improve data processes and decision-making. A top-notch QA manager will be someone whose quality assurance and data analysis expertise results in reliable information for company executives.

Duties and responsibilities

• Provide a functional manager role for all QA reporting data staff
• Conduct QA reviews and test work items before user acceptance testing and final approvals by key stakeholders
• Prioritize work items and requests from key stakeholders
• Create and update Azure DevOps board tickets to improve reporting automation for manual steps.
• Identify any data quality/process improvement points, and create new or update SQL queries and stored procedures.
• Develop, implement and oversee the use of data analysis and quality assurance tools.
• Establish data quality standards (units, variable names) and develop policies and procedures for higher quality
• Analyze QA data to identify root causes of quality issues, track metrics, and predict future trends
• Design and implement data testing procedures, validating datasets and identifying inconsistencies
• Build and maintain reporting master document for each health plan and report by lines of business. Document will need to be maintained as additional instruction or clarification is received.
• Review all currently implemented compliance reporting technical specification documents and report template instructions to ensure current reporting logic and data definitions align with those requirements. Document will need to be maintained once created as new reports as requested by the health plans.
• Review all compliance report output to make sure the data aligns with the templates, all required information is complete, and data is in the correct format for each field.
• Check all compliance reports to confirm all ran on time and without error.
• Run any compliance reports manually ad-hoc as needed. Creates SOPs and documentation for running each report manually.
• Complete any manual steps to correct or make reports accurate.
• Identifies and corrects corrupt or inaccurate records.
• Drive process improvement of quality across all deliverables
• Running data queries to identify coding issues and data exceptions, as well as cleaning data.
• Revise our procedures and documentation that govern our internal and external policies and processes.
• Investigate and resolve questions and issues raised by audit activities.
• Other duties as needed.

Qualifications

• 10+ years' experience analyzing healthcare data for quality assurance and testing.
• 5+ years' healthcare administration experience.
• 2+ years' experience leading and supervising other staff and stakeholders
• SQL experience required.
• Proficiency writing up SQL queries and stored procedures
• Proficiency using Azure DevOps, Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe
• Demonstrated experience in analytical/problem solving, data visualization/reporting, and strong communication with agile mindset
• HMO/Medical Group experience preferred.
• EZ-Cap experience preferred.
• Detail oriented and highly organized
• Strong ability to multi-task, project management, and work in a fast-paced environment
• Strong ability in problem-solving
• Ability to self-manage, strong time management skills
• Ability to work in an extremely confidential environment.
• Strong written and verbal communication skills

Education and Additional Requirements

• Bachelor's Degree in Information Systems, Business Administration or similar discipline required
• Healthcare QA reporting data certification (CPHQ, CHDA, CDMP, HDM) or similar preferred