- Liaison to CMS and other governmental entities to obtain/provide information, identify issues and assists with timely responses to inquiries regarding contract.
- Responds to client inquiries via written or oral communications.
- Ensures contract compliance by monitoring deliverables, contract requirements, and communicating Medicare change requests.
- Works with other business units to ensure the effective coordination of objectives/deliverables, establish permissions in systems, perform quality review of deliverables to ensure compliance in accordance with applicable regulations within the scope of work, managing activities, and facilitating project by setting priorities.
- Coordinate and manage the transition of workloads, and serve as the interface with other entities.
- Contractor Administrator for CMSARTs system.
- Writes reports, prepares presentations, and ensures the timely approval by Program Director of deliverables.
- Provides training and technical advice to team members.
- Coordinates new CMS User ID set ups and background verifications.
- Works with Quality Director/Officer on ISO initiatives to improve operational systems, processes and policies to improve information flow, management reporting, business process and organizational planning.
- Facilitates project logistics such as meetings, conference rooms, conference calls, etc.
- Participates and/or leads internal/external committees as assigned.
- Problem Solving - Identifies and resolves problems in a timely manner.
- Customer Service - Responds promptly to customer needs; Responds to requests for service and assistance.
- Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.
- Planning/Organizing - Prioritizes and plans work activities; Organizes or schedules other people and their tasks.
- Communication - Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
- Mathematical Skills - Calculates figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
- Reasoning - Solves practical problems and deals with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
- Computer Skills - Intermediate proficiency with Microsoft Office to include Excel, Access, PowerPoint, Word and Outlook.
- High school diploma or GED required, Associates Degree in business preferred.
- At least 1 year of experience in an intermediate-level administrative position; or an equivalent combination of education and experience.
- Prior experience working with medical records strongly preferred.
- Prior experience working on government contracts strongly preferred.
- Intermediate proficiency with Microsoft Office to include Excel, Access, PowerPoint, Word and Outlook.
- Working knowledge of Medicare and/or Medicaid protocols for Fraud and Abuse investigations is preferred.
- Experience working with customer requirements and coordinating reports and deliverables.
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Operations Coordinator - Easton, United States - Qlarant
Description
Job DescriptionQlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.
As an Operations Coordinator at Qlarant, you will support our efforts to make a positive difference in the future of the Medicare and Medicaid programs. Our Program Integrity Contractors (UPIC West) team team identifies and investigates fraud, waste and abuse in the Medicare and Medicaid programs covering 16 Western states territories.
This position is based in our Easton, MD office. The hiring range for this position is up to $22/hour depending on experience plus an excellent benefits package with health insurance, two retirement plans, generous vacation, sick leave accruals and opportunities for advancement.
The Operations Coordinator's duties and responsibilities include the following. Other duties may be assigned.
To perform the job successfully, an individual should demonstrate the following competencies:
Education and/or Experience:
