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We are searching for a Quality Auditor - Configuration to support and develop programs aligned with Health Plan strategic goals through effective and timely assessments, data analysis, dashboard creation, education and implementation of processes and procedures that provide and maintain a cost-effective provider network for Texas Children's Health Plan. In this role you will be expected to have experience with technical competencies such as TFS, Visio, Microsoft Office and SQL
Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees unless approved for a medical or religious exemption.
· Create reporting and dashboards for Leadership.
· Proposes implements, and supports quality control measures related to practice and/or system changes that impact claims adjudication.
· Performs review of current and newly implemented processes to ensure accurate reports and/or other deliverables.
· Leads collaborations with other departments to ensure compliance standards are met.
· Prioritizes key project tasks and deliverables and identifies project risks, issues and dependencies.
· Become a subject matter expert for all areas within the Business Operations department.
· Create documentation to support growth, ensuring that all processes are documented, and maintained as process improvements occur.
· Contributes to the identification and development of specific processes as needed supports the creation of educational training for staff to integrate processes into existing workflows.
· Drives performance excellence and accountability by developing relationships with and working across departmental boundaries to eliminate identified barriers to creating new and maintaining existing requirements.
· Must have excellent written and verbal communication skills, and the ability to interact with a wide variety of individuals and handle several complex situations simultaneously.
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