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Clinical Quality Assurance Coordinator - Supervisor
MCMC, LLC Rockville, MD
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Clinical Quality Assurance Coordinator - Supervisor

MCMC, LLC
Rockville, MD
Expired: November 20, 2023 Applications are no longer accepted.
  • Vision , Medical , Dental , Paid Time Off , Retirement
  • Full-Time
Overview

MCMC is seeking a Weekend Supervisor.

The Weekend Supervisor (internally known as Clinical Quality Assurance Coordinator - Supervisor) is responsible to oversee the daily workflow of the Quality Assurance Department and provide leadership and direction to ensure operations run as efficiently and effectively as possible. This position is required to have a complete understanding of the duties required below and provide overall direction and support to the Quality Assurance Department.

This position is 100% remote and the schedule will be either Friday through Monday from 8:00-6:30pm EST or Thursday through Monday from 8:00-4:30pm EST.

Responsibilities

  • Coordinate and direct the QA department's daily workflow to ensure all product lines are completed with the highest level of quality in the most effective and efficient manner possible.
  • Prioritizes and manages the daily workload and ensures the appropriate and equitable distribution of work is maintained in order to achieve daily, weekly and/or monthly goals.
  • Consistently monitors work products to ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations and that specific indicators and criteria in accordance with company policy and procedures have been achieved.
  • Ensures department compliance of all federal ERISA and/or state mandates is adhered to at all times.
  • Promotes effective and efficient utilization of all clinical resources and makes necessary recommendations for improvements to management as needed.
  • Ensures all client relationships are maintained and all client specific requirements are met.
  • Assists promptly in resolution of any physician and/or customer complaints or quality assurance issues.
  • Delegates work as needed and provides backup to all departmental positions as required.
  • Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures.
  • Participates in the development and implementation of policies and procedures in order to promote and achieve the most efficient operation possible.
  • Participate in various educational and or training activities as required.
  • Perform other duties as assigned.

SUPERVISORY RESPONSIBILITIES

Directly supervise and carry out supervisory responsibilities in accordance with ExamWorks' policies and applicable laws. Responsibilities include, but are not limited to:
  • Carries out all supervisory responsibilities in accordance with the company's standards, policies, and all applicable employment laws.
  • Provides support, training, tools, and techniques to assist staff in achieving department goals and standards.
  • Oversees the completion and approval of employee timecards and coordinates overtime needs with management and staff as needed.
  • Encourages positive morale, maintains harmony among staff and resolves grievances when necessary.
  • Actively participates in the departments hiring and employee separation needs.
  • Communicates change effectively and prepares and supports those affected by change accordingly.
  • Actively participates in observing employee performance and documents performance issues as needed.
  • Supervise insubordinate staff when warranted and initiate corrective or disciplinary actions as required and/or directed by upper management.
  • Ensure periodic performance feedback is communicated with all staff and report any performance concerns, recommendations for job placement and/or growth opportunities to management.
  • Actively participates in successfully conducting annual performance evaluations.
  • Works directly with the department manager to ensure all staffing needs are met and the best working environment is achieved.


Qualifications

High school diploma or equivalent required. A minimum of three years related experience; or equivalent combination of education and experience. Knowledge of the insurance industry, preferably claims management relative to workers' compensation, no-fault, liability, and disability is desired.Previous supervisory experience preferred.

Registered Nursing license may be required in certain business locations of the company.
  • Must possess a working knowledge of medical legal aspects of medical records and health information principles and/or liability.
  • Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.
  • Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
  • Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Excel, and the Internet.
  • Must be a qualified typist with a minimum of 40 W.P.M.
  • Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
  • Analyzes problems involving multiple interrelated causes. Where necessary, gathers information and applies complex concepts or methods to generate an effective solution.
  • Ability to follow instructions and respond to upper managements' directions accurately.
  • Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
  • Must be able to work independently, prioritize work activities and use time efficiently.
  • Must be able to take independent actions and calculated risks when needed.
  • Uses good judgment and includes the appropriate people in the decision-making process.
  • Must be able to maintain confidentiality.
  • Must be able to demonstrate and promote a positive team -oriented environment.
  • Must be able to stay focused and concentrate under normal or heavy distractions.
  • Must be able to work well under pressure and or stressful conditions.
  • Must possess the ability to manage and direct change, delays, or unexpected events appropriately.
  • Demonstrates reliability and abides by the company attendance policy.

ABOUT US:

MCMC completes over 100,000 reviews each year for more than 400 clients, including almost all of the nation's largest Health Plans, PBMs, Disability Carriers, TPAs, UR companies, Self-Insured Employers, Taft-Hartley Plans and Government Organizations.

MCMC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

Equal Opportunity Employer - Minorities/Females/Disabled/Veterans

MCMC offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Address

MCMC, LLC

1451 Rockville Pike

Rockville, MD View All MCMC, LLC Jobs
20853 USA

Industry

Technology

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