Quality Manager

JOB TITLE: Manager Quality Assurance

REPORTS TO: AVP Quality Assurance

General Summary:

We are seeking a dynamic and experienced Manager, Quality to lead our quality assurance team within the healthcare domain. This role is pivotal in ensuring high standards of transactional quality, driving continuous process improvement, and enhancing process training initiatives. The ideal candidate will have a strong background in healthcare operations, a proven track record of quality management, and the ability to lead cross-functional teams to achieve excellence. The Quality Manager is responsible for leading and managing the quality assurance team to ensure operational excellence and compliance with organizational standards. The Manager collaborates with senior leadership to develop strategic audit plans, set financial targets, and define staffing objectives. Additionally, they conduct quality control audits, analyze findings, and provide actionable recommendations to enhance performance. The role requires strong problem-solving skills to determine when issues need internal escalation or direct client involvement.

Education & Experience:

1. Graduation and clearance of all major exams (SSC, HSC, qualifying degree).
2. 5+ years of experience in quality management within the healthcare industry, with a focus on transactional quality and process improvement.
3. Strong knowledge of healthcare operations claims processing, billing, coding, and regulatory requirements.
4. Proven expertise in process improvement methodologies (e.g., Lean, Six Sigma).
5. Must be Six Sigma certified with transactional quality and process improvement exposure.

Job Responsibilities:

• Ensure adherence to the companys policies and procedures.
• Act as an interface between the quality assurance executives and management.
• Ensure adherence to the client specific SLAs.
• Ensure quality activities are in line with documented procedures and manage the day-to-day/routine operations.
• Have supervisorial responsibilities to delegate work and ensure that targets are achieved & reporting timelines are met.
• Monitoring performance by gathering relevant data and producing statistical reports.
• Conduct Monthly one-one session with the team to identify gap areas and initiate action plan accordingly.
• Conduct calibration sessions with the quality auditors and the operation team leaders to ensure they are in sync with the client / program expectations.
• Organize brainstorming sessions among the quality auditors and team leaders to find out the best possible way to tackle current issues / problems.
• Analyze data to identify areas for improvement in the quality system.
• Develop, recommend and monitor corrective and preventive actions.
• Identifying relevant quality-related training needs and delivering training.

• (E.g. Feedback Delivery Method, Monitoring Methods, Data Analysis etc.)

• Process Improvement:

• Identify opportunities for process enhancement, reduce inefficiencies, and improve operational workflows.
• Lead process improvement initiatives using methodologies like Lean, Six Sigma, or Kaizen.
• Collaborate with cross-functional teams to implement best practices and standard operating procedures (SOPs).Lead Process Improvement Projects

• Strive for continual improvement of the existing quality monitoring systems and the processes by which they are developed.

• Process Training & Development:

• Design and deliver training programs focused on quality standards, process improvements

• Mentor and develop team members, fostering a culture of continuous learning and improvement.

• Stakeholder Management:

• Work closely with operations, compliance, and client teams to align quality objectives with business goals.
• Manage escalations effectively, ensuring timely resolution of quality-related issues.

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