Manager, Quality Assurance (Complaints & Grievances)

What Will Your Job Look Like?

The Manager, Quality Assurance is responsible for the supervision and monitoring of the assigned Quality Management staff with a primary function of assuring compliance with client requirements and MTM policies and procedures. 

This is a work from home position.

What You’ll Do:

• Provide day-to-day oversight of direct reports
• Delegate projects and departmental assignments through efficient utilization of staff
• Provide correspondence, assistance and feedback for departmental strategic planning sessions and for the development of new/revised procedures
• Work closely with internal stakeholders to address client concerns and issues
• Provide training for newly hired staff
• Oversee Quality reports submitted to the client to ensure accuracy
• Track and trend QSR training and education needs
• Develop quality monitoring reports to meet client requests
• Monitor staff for accuracy
• Conduct timely/accurate reviews
• Act as a subject matter expert during Client meetings
• Provide support and assistance for special projects, client audits, and Corrective Action Plans as needed
• Ensure timely/accurate submission of payroll and other required paperwork
• Maintain accurate record keeping
• Ensure staff attends mandatory training sessions
• Provide monthly observation scores for assigned staff
• Provide oversight and timely submissions of No-Show Process monthly summary reports
• Ad hoc departmental reports upon request

What You’ll need:

• High School diploma or G.E.D. equivalent
• 5 years’ experience in a Quality or Compliance role (or a similar role)
• At least 3 years’ supervisory experience
• 2 + years’ experience interacting with clients
• Prior experience working with healthcare grievances & appeals
• Prior experience working with Quality Management processes, Managed Care and Federal and State regulations regarding complaint and appeals
• Proficiency in the Microsoft Office

Even better if you have...

• Experience working for a managed care organization or healthcare provider preferred
• Previous experience in Medicaid or State public assistance programs preferred
• Ability to work with stakeholders and employees at every level
• Strong writing skills
• Strong organizational skills
• Knowledge of medical terminology
• Demonstrate excellent time management skills
• Knowledge of transportation logistics, preferably ambulance providers, including state and local regulations
• Persuasive negotiator
• Proficiency in the Microsoft Office
• Analytical skills in using data to drive operational and cost improvement
• Working knowledge of Customer Service protocols and procedures preferred
• Data analysis and interpretation skills
• Excellent interpersonal skills
• Ability to schedule, organize and prioritize multiple tasks
• Knowledge of budgets and cost analysis preferred
• Excellent communication skills
• Bi-lingual in Spanish preferred

What’s in it for you:

· Health, Life Insurance, Dental and Vision Plans

· 401(k) with a company match

· Flexible Scheduling

· Paid Time Off, Holiday Pay and Birthday Holiday

· Maternity/Paternity Leave

· Casual Dress Environment

· Tuition Reimbursement

· MTM Perks Discount Program

· Milestone Anniversary One Month Sabbatical

· Leadership Mentoring Opportunities

Salary Range:

Salary Min: 64,480

Salary Max: 90,000

This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss with us as you move through the selection process.

Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM’s People & Culture.

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