Healthcare Operations Quality Assurance (Hybrid Warwick, RI)

Your role in our mission

• Performs routine to complex tasks related to various Medicaid operations and policies.
• Maintains compliance with multi-layered and dynamic regulations and policies.
• Maintains quality metrics and service level performance metrics to ensure efficient and effective workflow practices.
• Affords support to business function managers and leaders in addressing quality issues.
• Prepares and distributes monthly leadership presentation materials with clients.
• Applies knowledge of established policies and procedures to research and resolve issues ensuring compliance.
• Exercises independent judgment within defined practices and procedures to determine appropriate actions.
• Evaluates unique circumstances and makes recommendations.
• Facilitates various audits including annual independent third-party audit, bi-annual PERM audit, annual false claims act compliance audit, and other periodic internal and external quality audits.
• Trains peers and takes the lead in areas of expertise.

What We're Looking For

• Excellent oral and written communication skills.
• Strong analytical skills.
• Self-motivated with excellent time management and organizational skills, able to work independently as well as part of a team.
• Effective prioritization and handling of multiple tasks and working under aggressive time constraints.
• Excellent problem-solving and decision-making skills.
• Experience with Microsoft Office, Word, PowerPoint, Excel.

What You Should Expect In This Role

• Hybrid – Rhode Island: Candidates will be required to attend in-person meetings in Warwick and work from the office as business needs dictate.
• Training may require additional time in the office to support onboarding and knowledge transfer.
• The deadline to submit applications for this posting is 08/01/2026.
• The pay range for this position is $50,400.00 - $72,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.