Providence caregivers are not simply valued – they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Quality Assurance Manager who will: Be responsible for self-insured insurance program's Medicare Secondary Payer Reporting requirements
Ensure NPDB settlement reports are submitted timely and accurately
Promptly and accurately submit regulatory reports to state governing agencies within Providence's footprint
Manage Payor Contracting Requests, including running data reports and providing appropriate loss information
Timely and accurately report claims to excess carriers
Complete Next of Kin searches
Provide educational support to claims professionals
Review, revise, and develop policies and procedures, as needed and upon request
Run metrics reports
Work collaboratively with fellow teammates
Manage multiple time-sensitive priorities
Work independently in a fast-paced environment
Be adaptable
Providence is welcoming 100% remote work for residents who reside in the following States: Alaska
Washington
Oregon
Montana
Idaho
California
Nevada
New Mexico
Texas
Required qualifications for this position include: Bachelor's Degree in Management, Administration, Organization, Social Work Administration, or another related field of study -OR- a combination of equivalent education and experience
5+ years of experience in quality assurance working with liability claims and/or insurance
Preferred qualifications for this position include: Master's Degree in Management, Administration, or another related field of study
Coursework/Training: Training in risk, claims, and insurance
Applicable certifications in quality assurance or education
2+ years of experience developing policies and procedures and education for department in claims and/or insurance
Civil Tort claims handling experience
Risk Management Experience
Experience working with Medicare Secondary Payor Reporting
Experience handling Payor Contracting requests
Experience with State and Federal settlement reporting
Regulatory experience
Experience working within a healthcare organization
Salary Range by Location: AK: Anchorage: Min: $44.24
Max: $70.03
AK: Kodiak, Seward, Valdez: Min: $46.11
Max: $73.00
Washington: Western: Min: $46.11
Max: $73.00
Washington: Southwest - Olympia, Centralia & Below: Min: $44.24
Max: $70.03
Washington: Tukwila: Min: $46.11
Max: $73.00
Washington: Eastern: Min: $39.36
Max: $62.32
Washington: South Eastern: Min: $41.24
Max: $65.29
Idaho: Min: $39.36
Max: $62.32
Oregon: Portland Metro Region: Min: $44.24
Max: $70.03
Oregon: All cities outside of Portland: Min: $41.24
Max: $65.29
California: Northern California: Min: $51.74
Max: $81.90
California: Humboldt: Min: $46.11
Max: $73.00
California: Southern California: Min: $46.11
Max: $73.00
California: Bakersfield: Min: $44.24
Max: $70.03
Montana: All cities outside of Great Falls: Min: $35.62
Max: $56.38
Montana: Great Falls: Min: $33.74
Max: $53.42
Nevada: Min: $46.11
Max: $73.00
New Mexico: Min: $35.62
Max: $56.38
Lubbock, Levelland, Plainview TX: Min: $33.74
Max: $53.42
TX: Austin, Dallas, Houston, San Antonio: Min: $44.24
Max: $70.03
Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 281506
Company: Providence Jobs
Job Category: Financial Transactions
Job Function: Health Plans Services
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 4008 SS RIS
Address: CA Irvine 3345 Michelson Dr
Work Location: Providence Health System Office-Irvine
Pay Range: $See Job Posting - $See Job Posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
