NEOGOV · 5 months ago
Quality Control - Coordinator 2
Baton Rouge, LA
Full-time
Onsite
Entry, Mid Level
2+ years expNEOGOV is associated with the University of New Orleans and is seeking a Quality Control Coordinator 2. The role involves reviewing and analyzing Medicaid and CHIP eligibility cases, ensuring audit documentation is maintained, and assisting in training staff to improve the quality of Medicaid certifications.
GovTechHuman ResourcesInformation TechnologySoftware
Responsibilities
Reviews, analyzes, and investigates assigned Medicaid and CHIP eligibility cases to determine their validity and accuracy based on policy, procedure, and information found within the various Medicaid systems
Completes special eligibility quality control research projects as assigned by LDH
Ensures audit documentation is maintained and distributed appropriately
Emails the appropriate sections when corrective action is required on a case review and log findings. Incumbent may also be required to follow up with different types of third party institutions as part of the audit process to validate information or follow-up on information that is unclear or incomplete and prepare in- depth written case review analyses and reports
Assists the Department in establishing training needs for staff in an effort to reduce errors and increase the quality of Medicaid certifications
Reviews changes to Medicaid policy and procedures and attend meetings with Medicaid staff
Serves as backup to other Quality Control employees
Works with LDH in identifying reporting/statistical needs in relation to Medicaid eligibility quality control review of cases
Gathers quantifiable information from cases completed and compile statistical data on the Medicaid Eligibility Quality Control and PERM reviews performed by the unit
Assembles charts and diagrams with the statistical information and provide visual charts to depict results of case reviews of special projects and pilots as assigned
Assists with the development of the systems and applications utilized by the department to capture the necessary information electronically to be used for statistical computations
Assists Coordinator 3 (C3) with ensuring MEQC unit meets all requirements for audit duties assigned by LDH relative to applicable Federal Medicaid Integrity Programs, including Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC)
Completes secondary review requests, and update the review findings along with any changes that result from the secondary reviews
Completes special eligibility quality control research projects as assigned by LDH, and maintain the team’s special QC project files
Assists the Department in establishing training needs for staff with the objective of reducing errors and increasing the quality of Medicaid certifications
Assists the C3 in creating pilot report forms and identifying reporting/statistical needs in relation to the Medicaid Eligibility Quality Control review of cases
Assists the C3 in assembling charts and diagrams with the statistical information and provide visual charts to depict results of case reviews of special projects and pilots as assigned
Ensures that QC staff are meeting expected project deadlines and communicate with the unit supervisor regarding any project deadline issues that arise
Assists the C3 in developing and maintaining the Medicaid Quality Control Manual, shared storage sites, pilot review forms and guides, and other QC departmental procedure instructions to ensure that they are organized and current
Attends meetings with Medicaid staff and assist with researching and troubleshooting policy related issues that tie to case reviews. Assist supervisor with assessment of Program Integrity needs and attend meetings with Program Integrity staff
Conducts an annual performance evaluation for each subordinate, setting future goals and strategies
Conducts recruitment, selection, training, supervision, and professional development of assigned staff
Serves as backup to the QC C3
Other duties as assigned
Qualification
Required
Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience
Minimum 2 years of professional experience in health care field, Medicaid/CHIP eligibility or Medicaid program support
Minimum 1 year of experience of working with Medicaid Eligibility Quality Control or Program Integrity, or Medicaid policy/procedures
Excellent analytical skills, effective organizational and time management skills
Great attention to detail and follow up, and verbal/written communications skills
Intermediate Microsoft Excel Skills
Preferred
Advanced Degree
Minimum 3 years of professional experience in health care field, Medicaid/CHIP eligibility or Medicaid program support
Minimum 2 years of professional experience working with Medicaid Eligibility Quality Control, Program Integrity, or Medicaid policy/procedures
Minimum 1 year of experience with data analysis or compiling statistical data
Minimum 1 year of professional supervisory experience
Company
NEOGOV
NEOGOV is the leading provider of workforce management software uniquely designed for the public sector, education, and public safety.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$700MKey Investors
Warburg Pincus
2025-07-28Secondary Market· $700M
2025-07-28Acquired
2021-06-02Private Equity
Leadership Team
Shane Evangelist
CEO
Brandon McDonald
Head Of Marketing
Recent News
Canada NewsWire
2025-11-14
2025-11-14
Government Technology US
2025-10-31
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