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Quality Assurance Analyst - Enrollment
Quality Assurance Analyst - EnrollmentDenver Health • Denver, CO, United States
Quality Assurance Analyst - Enrollment

Quality Assurance Analyst - Enrollment

Denver Health • Denver, CO, United States
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We are recruiting for a motivated Quality Assurance Analyst - Enrollment to join our team!

We are here for life's journey.

Where is your life journey taking you?

Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all :

Humanity in action, Triumph in hardship, Transformation in health.

Department

Enrollment Services

Job Summary

Under general supervision, conducts quality assurance reviews of work completed in the Enrollment Services Department. Maintains and enforces a quality assurance program that promotes continuous improvement; assists trainers in the development and delivery of training materials for new hires and provides ongoing training and support to Enrollment staff.

Essential Functions :

  • Ensures the accuracy of data entry into the Colorado Benefits Management System and Denver Health internal systems by performing case reviews. (15%)
  • Conducts one-on-one coaching with Enrollment Specialists on a monthly basis concerning State CBMS system and Denver Health internal systems. (15%)
  • Serves as "gatekeeper" for the Enrollment Services department by transferring cases to Enrollment Specialists and / or County Human Services departments. (5%)
  • Monitors trends to minimize preventable errors and rectifies performance through coaching in order to reduce incorrect Medical Assistance program eligibility approvals. (10%)
  • Actively identifies problems and opportunities for improvement; identifies appropriate solutions and involves others in the implementation process. (5%)
  • Ensures compliance with all federal and state statutes, policies, regulations, legislative initiatives. (5%)
  • Provides training and support to Enrollment staff regarding CBMS, Medicaid, Buy-In, CHP+, CICP, DFAP and Connect for Health Colorado policies and procedures. (5%)
  • Helps collect case files in response to internal and external audit requests, and prepares responses to any resulting audit findings. (5%)
  • Resolves CHP+ appeals under the direction of the training manager. (5%)
  • Researches and submits help desk tickets to the Governor's Office of Information Technology for the entire department. (5%)
  • Works closely with State entities to resolve high profile and problematic buy-in cases. (5%)
  • Promotes positive interpersonal relationships with fellow employees, physicians, patients and visitors. Treats all individuals with courtesy, dignity, empathy, and respect; consistently displays courteous and respectful verbal and non-verbal communications. (5%)
  • Compiles and completes various reports. (5%)
  • Completes all duties and responsibilities in a non-discriminatory manner regardless of age group(s), cultures, religions, gender, race, and sexual orientation of the patients / clients to whom service is being provided. (5%)
  • Complies with and demonstrates support for the vision, mission, and values of Denver Health. Supports and adheres to the Denver Health Code of Conduct. (5%)

Education :

  • High School Diploma or GED Required
  • Work Experience :

  • 1-3 years of experience with the State CBMS system Required
  • Licenses :

    Knowledge, Skills and Abilities :

  • Advanced knowledge of medical and / or public assistance programs including Medicaid, CHP+, CICP, DFAP, and Connect of Health Colorado health plans.
  • Knowledge of federal and Colorado Statutes, legislative initiatives and regulations, as well as federal, state and local policies.
  • Advanced knowledge of the eligibility determination system CBMS.
  • Skilled in analytical thinking, problem solving, and process improvement.
  • Skilled in providing excellent customer service.
  • Ability to disseminate program information, policies, rules and regulations.
  • Ability to train, mentor and coach Enrollment staff for continuous improvement.
  • Ability to communicate orally and in writing in a thorough, clear, and professional manner.
  • Ability to simultaneously coordinate and manage several functions, programs, and tasks in various stages of completion.
  • Ability to consistently implement program, department and organizational policies and procedures.
  • Ability to work well in teams and independently to get projects done, and to work with those at all levels of the organization.
  • Ability to quickly adapt to change.
  • Other duties as assigned.
  • Bilingual preferred.
  • Proficient in Microsoft Word, Excel, PowerPoint and Outlook.
  • Knowledge of CBMS, Salesforce, Five9 and Epic systems.
  • Shift

    Work Type

    Regular

    Salary

    $24.53 - $36.80 / hr

    Benefits

    Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans

    Free RTD EcoPass (public transportation)

    On-site employee fitness center and wellness classes

    Childcare discount programs & exclusive perks on large brands, travel, and more

    Tuition reimbursement & assistance

    Education & development opportunities including career pathways and coaching

    Professional clinical advancement program & shared governance

    Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program

    National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

    Our Values

    Respect

    Belonging

    Accountability

    Transparency

    All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.

    Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.

    As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

    Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

    Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.

    Applicants will be considered until the position is filled.

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