Quality Assurance Analyst - HRSN

Job Summary

This position provides timely and accurate quality assurance, administrative, and analytical support for CareOregon’s internal Rent Assistance team and the Health-Related Social Needs (HRSN) benefit. The role ensures member benefit allocations and payments are accurate, timely, and compliant with applicable regulatory, contractual, and organizational requirements.

About the Role

The role is hybrid, requiring one day per week in the downtown Portland office. Candidates must be located in the Portland Metro area.

Responsibilities

• Conduct timely and accurate quality assurance reviews of member benefit allocations prior to payment, ensuring alignment with state and federal regulations and CareOregon policies.
• Review supporting documentation and system data to validate eligibility, benefit limits, accuracy of calculations, and appropriateness of payment amounts.
• Identify trends, patterns, and root causes of errors; proactively recommend corrective actions to improve quality, consistency, and productivity.
• Research claim, invoice, enrollment, and benefit processing issues to determine source, contributing factors, and appropriate resolution, escalating issues as needed.
• Collaborate with the Rent Assistance team to reduce rework by clarifying requirements, identifying gaps in documentation, and recommending process or workflow improvements.
• Develop, maintain, and distribute summary-level, quality assurance, and performance reports for leadership and the Oregon Health Authority (OHA).
• Analyze data and quality review results to identify improvement opportunities, compliance risks, and training needs.
• Track corrective actions and outcomes to assess effectiveness of improvement efforts over time.
• Support audits, inquiries, and data requests by preparing accurate documentation and responsive analyses.
• Support the development and delivery of training materials, job aids, and guidance to proactively address quality trends, common errors, and policy updates.
• Partner with management and cross-functional teams to ensure quality assurance reviews remain effective, relevant, and aligned with organizational needs.
• Participate in meetings and workgroups related to HRSN benefits, rent assistance operations, and quality improvement initiatives.

Requirements

• Minimum 2 years’ experience in data quality assurance to include data entry, tracking, and reporting.
• Minimum 4 years’ experience in Medicaid, health plan operations, or managed care organizations.
• Preferred experience in managed care, quality assurance or improvement, and collaboration on or managing projects.
• Housing familiarity.

Qualifications

• Knowledge of Microsoft Office system, including intermediate Excel skills.
• Knowledge of basic medical terminology.
• Knowledge of care management platforms and experience with documenting in care management or similar platform.
• Knowledge and experience with Federal, State and Local regulations and HIPAA privacy rules and regulations.

Skills and Abilities

• Strong organizational skills.
• Attention to detail.
• Familiarity with Medicaid claims billing and coding.
• Computer skills and ability to learn new technology quickly.
• Good judgment, personal initiative, and discretion.
• Good written and verbal communication skills.
• Good customer service skills.
• Basic teamwork skills.
• Ability to manage multiple tasks.
• Ability to work in a fast-paced environment.
• Ability to work effectively with diverse individuals and groups.
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions.
• Ability to accept direction and feedback, as well as tolerate and manage stress.
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day.
• Ability to hear and speak clearly for at least 3-6 hours/day.

Organizational Responsibilities

• Support the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.