Note: The job is a remote job and is open to candidates in USA. The North Carolina Department of Health and Human Services (DHHS) is one of the largest agencies in the state, responsible for ensuring the health and well-being of North Carolinians. The Quality Assurance Analyst will assist with executing State required audit projects, tracking audit data, and supporting a team of auditors with case auditing and policy research.
Responsibilities
- Assist with the execution of State required audit projects
- Assist the Eligibility Audit Manager with tracking audit data and criteria to ensure the timely and successful completion of the audit
- Capture and log audit data in addition to calculating statistical rates
- Assist with case auditing as needed
- Support team of auditors by answering questions and conducting policy research
Skills
- Bachelor's degree from appropriately accredited institution and one year of experience related to the area of assignment; or an equivalent combination of training and experience
- Demonstrated knowledge of Medicaid policy to research, evaluate, and analyze eligibility determinations for all Medicaid programs
- Demonstrated knowledge and skill in utilizing the Medicaid eligibility system to evaluate beneficiary eligibility determinations and the MMIS claims system to obtain Medicaid payment amounts in an eligibility segment
- Demonstrated knowledge of statistical procedures including data collection, analysis, and report preparation
- Compliance monitoring experience for overseeing and managing quality assurance testing on an organization's day-to-day activities to ensure that compliance procedures are fully compliant with all regulatory requirements
Benefits
- Employees can participate in health insurance options
- Standard and supplemental retirement plans
- The NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
- Paid vacation
- Sick, and community service leave
- Paid parental leave is available to eligible employees
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