POSITION

Associate Operations Quality Assurance Analyst

LOCATION

This position is available to Virginia residents as Richmond or Lynchburg, Virginia in-office applicants or remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin.

At Genworth, we are committed to caring for our customers and for the safety of our colleagues. If you are working remotely, or during inclement weather/other circumstances which may make the office inaccessible, highspeed internet is required and a distraction free area is preferred.

YOUR ROLE

This candidate will perform audits on long term care claims processed by Claims associates, ensuring that the claims have been handled in accordance with the terms and provisions of the contract, with federal and state regulations and Standard Operating Procedures. Responsibilities include ensuring that claimants meet all contract benefit eligibility requirements, benefit payments are accurate, and that outbound correspondence is clear and appropriate. This candidate will drive success of the Quality Assurance programs by recommending process improvements and recognizing and communicating trends. Successful applicants will have the ability to build and maintain rapport with Claim associates as well as staying updated on procedural changes and maintaining knowledge of Claims processes. 

WHAT YOU WILL BE DOING

• Perform audits on transactions across USLI and meeting production and accuracy goals

• Delivering and presenting quality information and training in various team meetings, focus groups, pilots, and internal and external audit initiatives

• Provide training to Quality Associates on quality principles and auditing processes on multiple quality functions

• Provide mentorship for quality associates, including but not limited to, review of work, audits on auditors, and new hire mentorship

• Provide training and mentorship for vendor partners

• Other duties as assigned (i.e., pilot groups/processes, research regarding processes, SOP reviews, meetings and leading meetings as assigned)

• Verify quality auditing standards follow and are in accordance with the terms and provisions of contracts, company standards, with federal and state regulations and Standard Operating Procedures

• Drive success of the Quality Assurance programs by recommending process improvements and recognizing and communicating trends

• Establish and maintain rapport with associates, leadership, and management, well as staying updated on procedural changes and maintaining knowledge of USLI transactions

• Influences all levels of the organization to support programs, projects, and over all processes

• Identifies process improvements to ensure better quality for customer experience and adherence to compliance, legal, and risk standards 

• Acts as a change agent throughout the team

• Works to deadlines and work with multiple subject areas and priorities

• Meet attendance and company guideline requirements, and be able to flex schedule for meetings as needed

MUST HAVE / WHAT YOU BRING

• Two or more years claim adjudication and payment experience, paralegal experience, or other industry experience related to quality

• Medical knowledge, fluency with claim assessment terminology and medical record reviews

• Strong decision making, interpretive and analytical skills relative to assessing insureds current needs against contract language

• Ability to utilize claimant’s contract and other information provided to determine the accuracy of paid for services or identify the need for additional information

• Strong interpersonal skills, with ability to coach and provide effective feedback across all levels of the organization

• Excellent oral and written communication skills along with the ability to communicate and present to both associates and varying levels of leaders

• Demonstrated PC/Technical Skills – Windows based mainframe experience, as well as MS Office Suite (i.e., Excel, Word, Powerpoint)

• Ability to work independently and as a team

• Proven time management, prioritization, and organizational skills

• Flexible and open to change – ability to adapt positively to changing needs of the organization

• Ability to prioritize work assignments and strong decision-making skills

• Proven ability to set and meet aggressive goals

• Demonstrated ability to resolve conflict effectively and efficiently

• Strong analytical skills with a demonstrated ability to ensure controllership measures are effectively met

• High integrity, level of confidentiality necessary

NICE TO HAVE

• Experience in claims auditing or quality control

• Demonstrated understanding of single and cumulative medical conditions, including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential

• Able to understand and interpret contract language, complex insurance laws, state legislative laws, disability processes, nursing home licensing and rehabilitative requirements

• Demonstrable experience in making sound business decisions using risk management and quality protocols

• Familiarity and proficiency with Genworth Systems (i.e., PEGA, CLOAS, Calypso, etc.)

WHAT WE OFFER

• We have a real impact on the lives of the people we serve

• We work on challenging and rewarding projects

• We give back to the communities where we live

• We offer competitive benefits including:

  • Medical, Dental, Vision, Flexible Spending Account options beginning your first day  

  • Generous Choice Time Off your first full year

  • 12 Paid Holidays

  • 40 hours of volunteer time off

  • 401K Account with matching contributions

  • Tuition Reimbursement and Student Loan Repayment

  • Paid Family Leave

  • Child Care Subsidy Program

ABOUT US

Genworth Financial, Inc. (NYSE: GNW) is a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging. Headquartered in Richmond, Virginia, we apply our nearly 150 years of experience each day to helping people navigate caregiving options and fund their long-term care needs. Genworth is also the parent company of publicly traded Enact Holdings, Inc. (Nasdaq: ACT), a leading U.S. mortgage insurance provider. For more information on Genworth, please visit https://www.genworth.com/. From time to time Enact separately releases financial and other information about its operations. This information can be found at https://ir.enactmi.com/.

The mission of Genworth’s US Life business is to efficiently keep our promises to our customers and their families and to lead the industry forward to solve the nation’s long term care crisis.

We know we can’t deliver on our mission unless we deliver for our employees. That’s why we’re committed to creating a work environment that fosters diversity, inclusion, camaraderie, rewarding work, community involvement, and a focus on our employees’ well-being. We know each employee contributes in their own unique way and we’re dedicated to supporting every one of them to help them reach their full potential.