Sr. Quality Assurance & Compliance Analyst chez Adventist Health Glendale

Education and Work Experience:

• Associate's/Technical Degree in business administration, computer science or equivalent combination of education/related experience: Required
• Bachelor’s Degree in business administration, computer science or related field or equivalent combination of education/related experience: Preferred
• Five years' experience in absence management claims organization or integrated absence management (IAM) claims management system or related work experience: Preferred
• Five years' experience with business analysis, requirements gathering, business intelligence solutions (reports, metrics, dashboards and scorecards), preferably in the healthcare industry: Preferred
• Five years' experience working with HRIS and time and attendance information systems (Kronos and Oracle preferred).: Preferred

Essential Functions:

• Works collaboratively with information technology, HRIS, security, payroll, human resources, and third-party vendors to ensure successful interfaces are in place within the HR systems for accurate data recording and reporting. Works with and provides suggestions to both internal and external third-party development teams to design and deliver reporting and functional requirements like screen, interface and work system design. Partners with internal and external stakeholders to understand strategic claims and absence management strategy.
• Develops and maintains operations reports library; distributes reports and analytics on a scheduled calendared diary system. Provides efficient and accurate data reporting in support of the operational day-to-day integrated absence management (IAM) transactions related to leaves of absence, accommodations and workers’ compensation claims management. Generates loss run reporting for workers' compensation program. Develops and distributes trending and analysis reports. Coordinates and obtains data from third-party vendors. Designs, generates, analyzes, and delivers monthly, quarterly and year end IAM and workers' compensation reports. Develops and distributes adhoc operations reporting as needed.
• Establishes case management service level agreements (SLA) in collaboration with IAM stakeholders. Design and develop SLA Scorecards (departmental and end user) to measure service level performance. Develop and implement quality assurance audit reports to guide and improve service delivery, standard work, and regulatory compliance. Maintain quality assurance report library. Works with the IAM team to understand case management performance outcomes and improvement opportunities.
• Evaluates data and utilizes learnings to recommend workflow, systems and data management enhancements. Analyzes and monitors operational and claims management workflow for effectiveness and optimal performance. Designs and develops IAM target performance measures to monitor standard work compliance. Works with the IAM team and stakeholders to close gaps in standard work compliance. Documents and maintains internal documents, requirements, policies and communications to ensure company, department, and third-party vendor compliance. Designs and maintains SharePoint and collaboration sites.
• In collaboration with IAM and total rewards business stakeholders, develops and manages the IAM project road map (GANT); ensures all projects are accounted for and executed on within required timeframes. Leads efforts to initiate new projects. Establishes the project stakeholders, resources, milestones, deliverables etc. Engages with project stakeholders regularly to ensure projects are on task, milestones are met, and key deliverables executed upon. Reports out project roadmap activities/status to leadership.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.