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Proofreads and edits member/provider communications for accuracy and industry compliance standards, often through multiple rounds of edits. Manages turn-around times to ensure compliance with business and all state or government agency policy requirements. Identifies process improvement opportunities.
Conducts quality reviews on member and provider material/communications to ensure timely QA monitoring and meet any business or compliance turn-around times.
Reviews the original request, contracts and BRD against design to validate all requirements and quality are met.
Reviews vendor translations are appropriate.
Reviews vendor prototype to ensure a high quality deliverable.
Ensures the material meets the appropriate state or federal regulatory requirements.
Interacts cross functionally for issue resolution.
Conducts and facilitates meetings to determine appropriate audit process.
Tracks and maintains quality results for appropriate distribution.
Assists with the identification and communication of process improvement opportunities across operation areas based on quality audit review by monitoring trends.
Reviews content, fact-check information and raise flags about questionable or inconsistent information.
Acts as SME for appropriate LOB or business unit.
Assists with special projects and other duties as assigned.
Performs other duties as assigned.
Additional Responsibilities:Candidate Education:
Required A High School or GED
Preferred A Bachelor's Degree in Business, Communication, English or related field
Required 4 years of experience in directly related audit or quality assurance work
Preferred 2 years of experience in a customer service related type position
Preferred Other Government Sponsored Healthcare
Preferred Other Healthcare Regulatory Marketing guidelines
Intermediate Demonstrated organizational skills
Intermediate Ability to work in a fast paced environment with changing priorities
Intermediate Ability to multi-task
Intermediate Ability to proof large bodies of materials
Intermediate Ability to work within tight timeframes and meet strict deadlines
Intermediate Other Strong attention to detail
Intermediate Other Ability to remain calm under pressure
Intermediate Other Demonstrated technical expertise in performing quality reviews along with analysis of results
Licenses and Certifications: A license in one of the following is required: Technical Skills:
Required Intermediate Microsoft Outlook
Required Intermediate Microsoft Word
Required Intermediate Microsoft Excel
Required Intermediate Microsoft PowerPoint
Required Intermediate Other Knowledge of additional software programs as necessary