Quality Assurance & Compliance Specialist

🕒 2 days ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $47.1k - $67.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Support quality assurance, contract compliance, and governance activities for the Wisconsin Medicaid Management Information System (MMIS) contract • Partner with account and functional leaders to evaluate operational performance, identify quality and compliance risks, and drive improvements that support contractual requirements and service excellence • Analyze objective and subjective evidence to assess quality, identify root causes, recognize performance trends, and provide actionable feedback • Serve as a subject matter expert and escalation resource for complex or high-risk quality issues • Partner with leaders and staff to maintain and improve incident reporting, standard operating procedures (SOPs), corrective action plans, and other quality processes that support consistent execution • Evaluate compliance with policies, contractual requirements, service level agreements, laws, and regulations; identify gaps and recommend appropriate corrective actions • Develop formal reports and communicate quality, audit, compliance, and performance findings to leadership

🎯 Requirements

• Bachelor’s degree or equivalent combination of education and relevant experience • Three or more years of experience in quality assurance, contract compliance, operational quality, audit, or a related function; healthcare or insurance industry experience preferred • Experience applying audit concepts, practices, and procedures, with the ability to analyze findings, identify root causes, evaluate compliance, and recommend corrective actions • Experience working with business applications, operating systems, relational databases, and technology supporting contact center or back-office operations; experience with Verint and CXone is a plus • Strong analytical, problem-solving, communication, facilitation, and organizational skills, with experience managing multiple priorities, supporting change initiatives, and driving quality improvements

🏖️ Benefits

• generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies