QA Analyst

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Professional Engineering

Job Qualifications:

Skills:

Documentations, Quality Assurance (QA), Quality Standards, Writing

Certifications:

None

Experience:

2 + years of related experience

US Citizenship Required:

No

Job Description:

The Affordable Care Act (ACA) requires every state to establish a health insurance exchange (also called Health Insurance MarketplaceSM) to facilitate the purchase of health insurance for individuals and small businesses. Through the Center of Program Integrity (CPI), CMS has strong oversight and internal controls to protect consumers enrolled in the Marketplaces and safeguard taxpayer dollars. CMS develops and enforces rules for insurance agents, brokers, and others who assist with FFM enrollments. The Marketplace Program Integrity Contract (MPIC) is designed to support this oversight. Through research, investigation, and data analysis, the desired outcomes of the MPIC efforts are to prevent, detect, and resolve noncompliance with Marketplace rules, requirements, and laws; recommend administrative actions to CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified.

Summary:

This position will develop and apply quality standards in accordance with GDIT, MPIC, and customer requirements. Develops and conducts related reviews and development of processes. Ensures compliance is followed throughout quality assurance process. Coordinates and collaborates with internal and external partners to ensure quality standards are met and to establish standards. Reviews and edits materials to ensure grammar, content, and formatting are accurate and compliant. Additional work can include attending meetings and maintaining/developing associated documentation and collecting/maintaining staff training materials and annual certifications.

HOW YOU WILL MAKE AN IMPACT:

• Contributes to the completion of quality assurance projects.

• Strictly follow approved Standard Operating Procedures (SOPs) and related guidance and provide input into recommendations for SOP and guidance updates as needed.

• Reviews and edits material for punctuation, grammar, and content.

• Identifies and modifies contextual errors, reorganizes content, and edits graphics, tables, and illustrations.

• Assesses potential risks and compliance issues and provides recommendations.

• Implements quality standards and executes compliance on every stage of the process.

• Liaises with internal and external partners to ensure products or services meet the organization's quality standards, including collaborating closely with technical teams to deliver appropriate and complex content.

• Monitors and develops quality assurance strategies, including developing the process for crafting and refining of ideas, cultivating sources, and developing highly articulate articles.

• As needed, coordinates and performs quality trainings and documents the entire quality testing process.

• As needed, attends meetings and maintains/develops associated documentation.

• Safeguard PII and PHI

• Infrequent travel may be required

WHAT YOU’LL NEED TO SUCCEED:

• Bachelor’s degree or equivalency in healthcare field that includes 2-4 years’ ACA and/or Medicaid-Medicare experience

• 2 or more years’ experience with conducting documentation quality assurance, including editing, reviewing, and writing.

• Frequent work with workgroups to successful completion of goals and milestones

• Highly organized, ability to multi-task, and meet deadlines

• Proficient in computer skills, for example Microsoft Office-Word, Excel

• Requires only limited oversight to conduct work

• Strong interpersonal and communications skills, both written and oral

• Preferred Skills:

• Experience with FWA claims and investigations

• Experience with and/or understanding of ACA policies and regulations related to consumer enrollments requirements and Agent/Broker and Navigator responsibilities

• Location: Remote

• Security Clearance Level: Candidate must meet the residency requirement of having lived in the US for three (3) of the past five (5) years and p