Benefit Quality Assurance Analyst Job in Rockville, Maryland Us

Candidate will be responsible for:
- Supporting cross-functional Benefit Administration end-to-end quality improvement activities and initiatives.
- Validating that rates and group demographics have been correctly entered in TMS (KMate) by Group Data Base (GDB).
- Validating that the benefit structure, benefit summary and detail have been correctly configured by Contract Benefit Configuration (CBC) and loaded in TMS for all plan designs.
- Working with the Senior Analysts to learn how to audit BETS, Diamond and HealthConnect to provide backup support in auditing those systems.
- Creating and analyzing weekly, monthly and annual reports and metrics to identify errors and trends by applicable Benefit Administration areas.
- Implementing corrective actions to resolve issues prior to data being released for production.

Essential Functions:
- Audits the work of Benefit Configuration Analysts and Group Database Analysts as directed by manager and prepares both regular or adhoc weekly/monthly/annual audit reports for the audited units.
- Documents and reports patterns of errors for further analysis by management of the audited units.
- Assist with analyzing and resolving complex issues related to systems or processing procedures with the TMS system.
- Identifies trends and provides recommendations for corrective action plans.
- Participates in the planning, scheduling supervision of assigned audit projects.
- Assists management with systems and business processing improvement efforts.
- Provides innovative creative ideas to formulate new/improved audit approaches, tools techniques.
- Ensures that work papers contain adequate evidence to support audit findings.
- Demonstrates a knowledge and familiarity with Regional strategy and processes for on boarding new employer groups.
- Elevate issues for attention and resolution as appropriate.
- Maintain collaborative relationships and excellent communication with managers and staff in Benefit Administration and stakeholder departments.
- Contribute to improving the performance of the organization by identifying opportunities to improve organization systems/processes/deliverables and implementing these improvements.
- Maintain and update grids and tables as appropriate.
- Performs follow-up on implementation of documented changes concerning workflow and processes.
- Perform other duties as assigned.

Qualifications:
Basic Qualifications:
- 5 years of auditing or comparable experience required; to include increasing levels of internal project management experience.
- Bachelor's degree, preferably in business, information systems or related field, or equivalent (additional 4 years) combination of education and work experience is required.
- Demonstrated ability to plan, supervise perform integrated audits data analysis.
- Working knowledge of KMATE, BETS, DIAMOND, KPHC configurations.
- Understanding of detailed spreadsheet knowledge is required.
- Personal computer literary is required.
- MS Office experience is required.
Supplemental Staffing Unit (SSU) Requirements:
To deliver optimal services to our members, SSU employees:
- Must be available to work a variable and/or flexible 40 hours per week schedule as required.
- SSU assignments are FT/PT/PRN and Short term.
- Must be willing to work in different areas as required.
- Must be willing to work day, evening and night shift hours as required.
- Must be willing to work holidays and weekends as required.

Preferred Qualifications:
- Proven ability to deliver comprehensive audit reports in very short time frames to assure data is accurately entered prior to production.
- Consistently delivers high quality results, strives to improve his/her performance, demonstrates a sense of urgency, and improve.
- Demonstrated ability to interact effectively with staff being audited and their managers.

Schedule:
-This position is from November 2011-March 2012