Medicaid Lead Quality Specialist (MMIS / MES)

Description & Requirements

Description: The Quality Specialist is an integral role in on our implementation projects and actively participates in the implementation of technology and operational solutions for our clients.

The Quality Specialist will analyze existing processes, procedures, and metrics and identify opportunities for improved quality and efficiency as well as develop new procedures to ensure quality outcomes.

The position will be responsible for establishing a quality assurance strategy for new and existing clients including developing quality standards and identifying issues in the delivery of our products and/or services.

In addition, this position will be responsible for mentoring new implementation resources and the project management of high-profile projects with minimal oversight.

The role will contribute to new ideas and solutions, and innovate new tools and processes designed to optimize our implementation method.

This individual will act as a liaison between other Maximus leaders and the client.

Essential Duties and Responsibilities:

- Coordinate and communicate workload assignments across the QA team.

- Follow up as needed with team members to track progress and ensure on-time delivery of audits, retrospective reviews, and other QA department workloads.

- Coordinate the collection of departmental deliverables and submit them to manager on a timely basis.

- Serve as a subject matter expert for members of the QA team, answering questions and providing guidance regarding matters related to QA workload, assignments, and best practices.

- Lead cross-departmental calibration and QC challenge sessions.

- Assist with completing departmental workload, communicating with manager to problem solve, and review department documentation for purposes of updating as needed.



* Evaluate existing processes, identify quality gaps, and document recommended solutions.


* Monitor adherence to processes and document findings.


* Lead the development of comprehensive processes, procedures, and metrics to increate quality and efficiency.


* Provide guidance to the project teams on quality assurance and motivate team members to adopt and adhere to processes.


* Provide status reporting to leadership and stakeholders.


* Establish quality gates and controls for the project team.


* Monitor quality performance metrics and develop action plans as applicable

Minimum Requirements

- Bachelor's Degree or equivalent experience
- 7+ Years of experience

Required Qualifications:


* Experience with Medicaid Management Information Systems (MMIS) or Medicaid Enterprise Systems (MES).


* Six Sigma Black Belt is preferred.


* Minimum of 5 years of experience in guiding large organizations in the principles of quality assurance.


* Excellent written and verbal communication skills at various levels including executive leadership and external clients.


* Excellent time management and organizational skill...