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TriWest Healthcare Alliance · 12 hours ago

Contract QC Analyst

United States

Contract

Remote

Mid Level

$50K/yr - $56K/yr

3+ years exp

TriWest Healthcare Alliance is dedicated to serving America's heroes by connecting them to healthcare in the community. The Contract Quality Control Analyst supports the Supervisor of Provider Systems & Quality by performing quality control activities on provider contract and data records, ensuring accuracy and integrity, and identifying process improvements.

Health Care

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Maintains all audit tools for internal and external audits

Assists in conducting Daily/Weekly/Monthly audits of contract and data staff

Monitors accuracy of the provider contract and data by conducting periodic audits

Collaborate with multiple business partners including but not limited to Contracting Administration, Corporate Compliance, Claims Administration, and Legal to create strategies for contract templates while being proactive in preventing non-compliance

Manages executed contracts and amendments across multiple channels of the healthcare business

Develops and monitors quality reports and communications using contracting and provider data management systems

Assists in producing trend reports to improve workflow efficiency and system functions to recommend possible solutions to management

Assists with resolving data quality issues by identifying, documenting, and communicating quality issues

Assists with performing root cause analysis

Provides subject matter expertise

Performs other duties as assigned

Regular and reliable attendance is required

Qualification

Contract ManagementProvider Data ManagementQuality ControlData AnalysisEmptorisHealthcare ExperienceMicrosoft WordMicrosoft ExcelCommunication SkillsProblem Solving