Quality Assurance Analyst I

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

• Work-life balance - This is a remote role. Applicants must work from MD, VA, DC, PA, DE, or FL.
• Medical, Dental, and Vision Insurance.
• 403B Savings Plan w/employer contribution.
• Paid Time off & Paid holidays.
• Employee and Dependent Tuition assistance benefits.
• Health and wellness programs and MORE!

Who you are:

As a Quality Assurance (QA) Analyst in Health Services for Johns Hopkins Health Plans, you will perform operational and regulatory quality audits for Utilization Management, Care Management, and Appeals. You possess a strong analytical mindset and have a good understanding of the healthcare industry, particularly in managed care and health insurance. You possess excellent communication skills to effectively provide constructive feedback to various stakeholders, and facilitate positive interdepartmental relationships. Additionally, you are detail-oriented and able to maintain focus while working with large datasets and performing repetitive tasks.

What you’ll do:

• Provide support to Operations through Quality Assurance (QA) practices and oversight of operations functions
• Monitor call center agent calls for accuracy.
• Performs quality audits
• Analyze reports and/or information to identify data integrity issues
• Participates in testing and QA of system changes

What you’ll bring:

• Associate’s degree in business management, health care administration or related discipline, Bachelor’s degree preferred. Equivalent experience may be substituted for degree.
• 2 years of experience in operations functions preferably in a managed care setting.
• Knowledge and experience in Utilization Management, Care Management, and Appeals preferred.
• Experience with performing quality audits, analyzing outcomes, and making recommendations.
• Ability to work in multiple software applications and learn new applications quickly.
• Excellent communication skills, both verbal and written.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

Salary Range: Minimum 20.22/hour - Maximum 33.38/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.