Manager, Quality Assurance - Capital District Physicians' Health Plan : Job Details

Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Manager, Quality Assurance, will be responsible for the daily supervision and oversight of the quality staff and quality programs to ensure that departmental, divisional and corporate quality objectives are met. The incumbent will be responsible to design, develop and administer various quality programs including providing reporting solutions and trend analysis. They will ensure that the quality programs are administered effectively and in a timely manner. This position will work closely with seniors, supervisors, managers, and directors throughout the organization to ensure accuracy and excellent service are being provided to our customers. The individual will ensure that the company is delivering the highest level of service to the customer and act as a change agent to improve the quality of service.

Qualifications:

* Minimum three (3) years applicable experience in a call center and/or claims environment with specialization in management, staff education, quality assurance monitoring, and/or training is required.

* High school diploma or GED required. Associates degree preferred.

* Minimum 1 year management in health insurance is preferred.

* Demonstrated ability to analyze data, develop, implement, monitor and measure quality results is required.

* Demonstrated ability to retrieve, analyze data and strong problem solving skills that enable quick identification and efficient resolution of opportunities. Analytical software such as Access and Excel experience required.

* Ability to problem solve difficult claims and inquiries is required.

* Effective verbal and written communication skills are required.

* Strong written and verbal communication, organization and planning skills required.

* Experience in working in a team environment that promotes coaching and training and positive feedback to improve individual performance and customer satisfaction is required.

CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.

CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.