Medical Quality Assurance Specialist I job at QTC Management

Remote in ND, SD, NE, KS, OK, TX, MN, IA, MO, AR, LA, WI, IL, KY, MS, AL, MI, IN, TN, GA, FL, OH, NC, SC, WV, VA, PA, DC, CT, NJ, NY, RI, NH, ME, MD, DE, VT, MA

Job Type:

Employee

Job Schedule:

Alternative Schedule, Full-Time

Experienced

Travel Required:

No specification

Bachelor\’s/Undergraduate Degree, Professional Certification

Health Insurance, Retirement Savings, Disability, Paid Time Off

About the Role

Title: Medical Quality Assurance Specialist I

Location: Philadelphia, Pennsylvania, 19130, United States

Department: QA Compliance

Job Description:

Do you crave a career that truly makes an impact in people’s lives? Do you thrive on problem-solving and finding solutions? Join a dedicated, tight-knit team that creates an immediate and meaningful impact every day

Leidos QTC Health Services is seeking a Medical Quality Assurance Specialist on our Veteran Affairs Services team. You will work closely with medical providers and the Veterans Administration to ensure the documentation process is complete and accurate. In this role, you will review documentation sent over from medical providers and ensure the report is complete, concise, clear, and correct and the provider has accurately completed the Disability Benefit Questionnaires for delivery back to the VA.

*Position is remote but must live on the east coast of USA.
Primary Responsibilities:

• Review and audit exam reports sent over from medical providers
• Ensure all medical coding is complete and accurate
• Ensure all tests have been ordered and completed, and present in the medical record
• Coordinate with medical providers as needed for clarification of reports
• Work with our in-house appointment schedules to request additional appointments for the veteran as necessary

Required Qualifications:

• High School Diploma or equivalent (GED)
• Strong knowledge and understanding of anatomy and medical terminology
• Ability to read and analyze medical reports
• Aptitude to apply clinical reasoning (diagnostic testing)
• Ability to write clear questions to submit to the provider
• Experience working with medical providers (credentialing, medical coding, chart audits, triage, scribe, nursing)
• Understanding of case management software, electronic medical records and medical databases
• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

Preferred Qualifications:

• Allied medical professional certification, or relevant college, or vocational training in the medical field, i.e. LVN, CNA, Military Corpsman/Medic, EMT, MA, etc.
• Direct healthcare experience in medical case management or quality assurance to include the review of complex multi-focal medical reports for quality, clarity, thoroughness and insightful medical explanation
• Experience assisting with medical tests, treatments and procedures
• Knowledge of military medical examinations or experience working with the VA
• Understanding of general disability claims, workers compensation, or audits

Additional Information:

• Location: Remote – East and Central Time Zone Only
• Shift: Wednesday – Saturday – 7:00 am – 5:30 pm (EST)
• Training: 6 – 8 months of training period that includes coaching, mentorship, and proficiency verification. Upon graduation from training, an 8% pay increase is awarded.
• Probationary Period: Employment as a Medical QA Specialist will include successful completion of 120-day probationary period during which you will be given objectives to achieve. This timeframe lets you assess your readiness for the position as well as allows Leidos QTC Health Services to determine your ability to successfully perform the job. You will be provided objectives, documentation, training and performance feedback during the 120-day probationary period as part of your assimilation to the role. After successfully completing the 120-day probationary period, you will be considered a permanent employee.

Leidos QTC Health Services collaborates closely with government and non-government customers to address current and future program needs within the health services domain. We specialize in disability-focused medical examinations, independent medical exams and review services, occupational health services, diagnostic testing, and case management solutions. As innovators, we focus on advancing technologies that improve service delivery, with a particular emphasis on enhancing accessibility for examinees in rural communities. With a proven track record of continuous improvement and steady growth, we now handle over 2 million appointments annually. Visit www.qtcm.com for more information.

Compensation and Benefits

Pay and benefits are fundamental to any career decision. That\’s why we craft compensation packages that reflect the importance of the work we do for our customers. As a result, we offer meaningful and engaging careers to support you and your career goals, all while nurturing a healthy work-life balance. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here.

This role may fall under the Service Contract Act (SCA), a federal law which provides for a U.S. Department of Labor-prescribed minimum prevailing rate of pay and certain benefit levels. Where appropriate, Company-provided benefit plans such as comprehensive leave, holiday, medical, dental, life, accident, disability coverages, retirement plan contributions, and other health and welfare benefits and payments are utilized to meet these obligations.

Commitment to Non-Discrimination

All qualified applicants will receive consideration for employment without regard to sex, race, ethnicity, age, national origin, citizenship, religion, physical or mental disability, medical condition, genetic information, pregnancy, family structure, marital status, ancestry, domestic partner status, sexual orientation, gender identity or expression, veteran or military status, or any other basis prohibited by law. Leidos QTC Health Services will also consider for employment qualified applicants with criminal histories consistent with relevant laws.

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