Qualifications
Act as a full-time member of the PSLD Structure team. Possess comprehensive knowledge of PSLD workflows to provide precise quality assurance guidance and feedback, along with quality assurance insights for developing projects within the plan operation department on an ad hoc basis. Systematically monitor and evaluate service performance to ensure adherence to performance standards, identifying and mitigating risks, reducing costs, and proactively resolving issues. Manage and oversee the QA team’s performance while assisting in the development of process improvements, Standard Operating Procedures (SOPs), metrics, and other tools to streamline daily operations. Focus on quality assurance aspects such as prevention, appraisal, internal and external failures while emphasizing customer orientation, leadership needs, employee engagement, process improvement, evidence-based decision-making, and relationship management. Participate in Standard Operating Procedures for Disaster Recovery, Backup Plans, and Failover Plan Testing. Demonstrate in-depth knowledge of Knowledge Articles necessary for executing assigned SOPs and possess the ability to train others on their content and application. Engage in the continuous review of Knowledge Articles, ensuring accuracy, compliance, and ongoing enhancements. Maintain industry knowledge of services and regulations. Review proposals for improvement and lend support to projects aimed at enhancing SOPs and compliance with internal controls and external regulations. Support and maintain overall PSLD QA procedures and QA needs, along with collaborative project work upon team leader approval.
About the job
Collective Health creates tools and services that help employers and their teams get more value from health benefits. By blending technology with thoughtful service and a focus on user experience, the company aims to simplify how benefits are used and managed.
Role overview
The Senior Health Plan Quality Control Associate will be part of the Group Administration team within Health Plan Operations. This team manages specialized processes and collaborates with finance, legal, product, and other internal partners.
Team focus: Plan Structure, Launch & Design (PSL&D)
The PSL&D team creates and refines processes that support the Member Claims team and help client implementations run smoothly. This group is responsible for building and maintaining the business logic and systems that bring client healthcare plans onto the Collective Health platform.
About Collective Health
Collective Health is at the forefront of transforming the employer-sponsored health benefits landscape, utilizing advanced technology and a customer-centric approach to enhance the healthcare experience for employees and their families.