Oklahoma Quality Analyst, DentaQuest

Oklahoma Quality Analyst, DentaQuest

Ensure you read the information regarding this opportunity thoroughly before making an application.

Location : Individual must be located in the state of Oklahoma, Oklahoma City.

The Opportunity :

The Quality Analyst for the Quality oversight team is responsible for preparing, inspecting, and complying with contractual quality program requirements.

In this role, you will validate and / or develop improved standards, identify training needs, including root-cause analysis, and correction actions / recommend solutions for the Quality oversight department within Compliance.

How you will contribute :

Conduct comprehensive quality assurance assessments and audits to identify deviations, defects, and non-conformities with processes and service level metrics.

Report deficiencies to management.

• Develop and implement quality control audit plans.
• Train employees on quality standards and procedures.
• Prepare and present quality reports to senior management.
• Track and trend root cause analysis and corrective actions to address quality issues.
• Maintain quality meeting minutes for client distribution.
• Attend and participate in client meetings.
• Track quality contractual requirements and ensure compliance with such requirements.

What you will bring with you :

• Solid understanding of NCQA and / or URAC requirements.
• Detail-oriented and organized with the ability to prioritize tasks and meet deadlines.
• Strong analytical and problem-solving skills with the ability to conduct root cause analysis and implement corrective actions.
• Accountable for contributing to a workplace environment that fosters mutual respect, cooperation, information sharing, and commitment to delivering the expected service.
• Broad knowledge of Medicaid administration.
• Knowledge of federal and state laws / regulations applicable to quality and processes.
• Ability to think creatively to resolve complex or non-routine issues.
• Strong written and verbal communication skills and experience.
• Ability to effectively coach, develop, and motivate team members to achieve Department and SLF goals.
• Strong negotiation, decision-making, and problem-solving skills and experience.
• Ability to develop and maintain effective, professional business relationships across all levels of the organization and external TPA administrators and customers.
• Strong PC proficiency.
• Ability to successfully meet deadlines and achieve goals.
• Knowledge of company computer systems and products.

Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms.

If you think you might thrive in this setting, we would love to hear from you.

Life is brighter when you work at Sun Life

• Excellent benefits and wellness programs to support the three pillars of your well-being mental, physical, and financial including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company-paid life and AD&D insurance as well as disability programs and more.
• Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account.
• A flexible work environment with a friendly, caring, collaborative, and inclusive culture.
• Great Place to Work Certified in Canada and the U.S.
• Named as a Top 10 employer by the Boston Globe's Top Places to Work two years running.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

If you are a California resident, the salary range for this position is :

• Southern region : $55,200 - $82,000 annually.
• Central region : $58,200 - $87,300 annually.
• Northern region : $62,200 - $93,300 annually.

If you are a Colorado resident, the salary range for this position is $52,600 - $78,900 annually.

If you are a New York resident, the salary range for this position is $62,200 - $93,300 annually.

If you are a Washington resident, the salary range for this position is $58,200 - $87,300 annually.

We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives.

More than just a name, Sun Life symbolizes our brand promise of making life brighter for our customers, partners, and communities.

Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com / us to learn more.

LI-remote

Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans unless the accommodation would impose an undue hardship on the operation of our business.

Please email [email protected] to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

Job Category : Customer Service / Operations

Posting End Date : 26 / 09 / 2024

J-18808-Ljbffr