["Case Management Quality Control Analyst","Case Management Quality Control Analyst"]

Case Management Quality Control Analyst Responsibilities Review and evaluate the performance of Program Representatives in patient experience, FDA regulation of Adverse Events/Product Complaints, HIPAA compliance, and program‑specific policies using an approved quality scorecard.Analyze call trends through monitoring and collaborate with internal departments to develop solutions that improve the patient experience.Maintain a thorough understanding of company Standard Operating Procedures, processes, and policy requirements.Prepare and analyze internal quality reports for management review.Manage disputes and call requests received through the ServiceNow portal.Participate in internal and external calibrations to identify client needs and expectations.Facilitate new‑hire training and introduce program quality standards and expectations.Prepare call records and associated documents and participate in internal and external client audits.Locate specific call records through the recording system, provide findings, and edit recordings to remove Protected Health Information as required.Participate in internal department meetings as needed.Contribute to the design of call monitoring forms and quality standards.Identify and report pharmacovigilance information as required by the client (e.g., Adverse Events).Apply Valeris leadership competencies to drive team success.Adhere to training deadlines for all corporate policies and procedures governing access to confidential data.Ensure all SOPs are followed consistently.Perform miscellaneous tasks or projects as assigned.Qualifications High School Diploma or equivalent.2–3 years of experience in customer service, reimbursement/insurance, healthcare billing, physician office, or health insurance processing.QA/QC audit experience preferred.Maintain an internal quality average of 90% or higher (for internal applicants).Intermediate knowledge of FDA regulation of Adverse Events/Product Complaints and HIPAA guidelines.Motivated self‑starter with the ability to work independently and cooperatively within a cross‑functional environment.Ability to manage priorities without direct supervision.Flexibility and willingness to respond to changing circumstances and expectations promptly.Strong problem‑solving and independent decision‑making skills.Ability to collect, analyze, and visualize data in detail.Fairness and impartiality in evaluations.Professionalism, integrity, maturity, and a positive attitude.Excellent verbal and written communication and interpersonal skills.Strong planning, time management, attention to detail, and organizational skills.Comfortable interacting with all levels of management and diverse personalities.Basic knowledge of MS Office (Word, Excel).Basic knowledge of monitoring software preferred (e.g., Zoom Call Recording, Calabrio, NICE Call Recording).Availability for onsite training and/or in‑person client meetings as necessary.Physical Demands & Work Environment Employee is regularly required to talk or hear, sit for long periods, type, and handle materials. Prefer candidates who can type at least 35 words per minute with 97% accuracy. Minimal travel may be required. The role operates in a professional office environment using standard equipment such as computers, phones, and photocopiers.Benefits Medical, dental, and vision plans (includes HSA‑ and FSA‑eligible options, with Valeris contributing toward premium costs).Additional health support, including telehealth and Employee Assistance Program services.Company match on Health Savings Account contributions.Free basic life and accidental death and dismemberment coverage equal to annual earnings (minimum $50,000, maximum $300,000).Company‑paid short‑term disability coverage; option to purchase long‑term disability.401(k) retirement savings plan with 100% match on the first 5% contributed, with immediate vesting.Paid time off (PTO) and sick leave.Nine paid holidays plus two floating holidays.Opportunities for advancement and professional growth.Work environment that encourages new ideas and values diversity.Mission‑driven, inclusive culture that allows meaningful impact.Equal Opportunity Statement Valeris is a proud equal opportunity employer. We celebrate difference and ensure an inclusive workplace for all employees.#J-18808-Ljbffr