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Description

The Case Management Quality Control Analyst is responsible for reviewing and evaluating the performance of the Program Representatives as they complete their cases and Market Access and our clients to patients, providers, and pharmacies. This position requires the ability to work in a constructive, impartial, and collaborative manner by establishing positive work relationships, partnering with the Market Access Leadership team, Training, and Client base. This position requires the ability to gain the confidence and trust of others by demonstrating professionalism and expertise in an ever-changing environment.• Reviews and evaluates the performance of all representatives using an approved quality scorecard in the areas of patient experience, Federal and Drug Administration (FDA) regulations of Adverse Events (AE)/Product Complaints (PC) and Health Insurance Portability and Accountability Act (HIPAA) compliance, and specific program policies and procedures.

• Analyzes potential call trends through call monitoring and works with the internal departments to develop solutions to improve the patient experience.

• Responsible for resolving evaluation disputes as assigned and completing call requests received through ServiceNow portal.

• Participates in internal and external calibrations to identify Client’s needs and expectations.

• Participates in new hire training and introduces program quality standards and expectations.

• Participates in internal department meetings as needed.

• Identifies and reports pharmacovigilance information as required by client(s) (i.e., Adverse Events).

• Conducts miscellaneous tasks or projects as assigned

Skills

Pharmaceutical, healthcare customer service, billing and reimbursement software, case management, Quality assurance, Compliance, Quality control, supervisory skills, medical billing, medical insurance, call center experience

Top Skills Details

Pharmaceutical,healthcare customer service,billing and reimbursement software,case management,Quality assurance,Compliance

Additional Skills & Qualifications

• High School Diploma or equivalent required

• Minimum of 2 years of customer service, reimbursement/insurance, healthcare billing, physician office or health insurance processing experience required

• QA/QC audit experience preferred

• Intermediate knowledge of FDA regulations of AE/PC and HIPAA guidelines

• Must be a motivated self-starter with the ability to work independently but cooperatively within a cross functional environment

• Must be able to manage priorities while working independently without direct supervision and be able to direct and manage the work of others with a high level of professionalism and integrity.

• Ability to be fair and impartial

• Must be able to problem solve and make independent decisions with high level of confidence

• Must be able to collect, gather, visualize, and analyze data in detail.

• Display a high level of professionalism, integrity, maturity, and maintain a positive attitude

• Excellent verbal and written communication, interpersonal and listening skills

• Strong planning, time management, attention to detail and organizational skills

• Comfortable interacting with all levels of management and personalities

• Intermediate knowledge in MS Office (Word, Excel)

• Basic knowledge of monitoring software preferred (i.e., Calabrio, NICE Call Recording, etc.)

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $21.00 - $23.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Aug 1, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.