Under the Cost Reimbursement program, the Social Security Administration pays State Vocational Rehabilitation (VR) agencies compensation in the form of reimbursement when beneficiaries served by State VR agencies enter the workforce and achieve nine continuous months of earnings. State VR agencies can serve as Employment Networks (EN) in the Ticket to Work (Ticket) program or under Social Security's State VR Reimbursement Program. State VR agencies are the only programs authorized by law and automatically approved to provide service to beneficiaries under the Ticket program without becoming an EN.
Maximus VR QA Analysts work with SSA to initiate and implement quality control and quality assurance activities into processes resulting in an effective method for ensuring that VRs are properly compensated. VR QA Analysts ensure ongoing efforts to meet quality performance goals and improve the accuracy and timeliness of Cost Reimbursement (CR) payment processing, help minimize unnecessary draws on SSA funds and maintain strong relationships with VRs
- Assist in developing metrics for Maximus VR Quality Control Process.
- Perform both In-Line and End line Reviews of VR claims.
- Liaison with VR staffs to identify/resolve complex VR payment-related issues.
- Develop agenda, participate in All VR Calls and produce recaps of calls.
- Apply knowledge of QMS processes and document control to meet the compliance of ISO 9001 business needs.
- Ensure activities and processes comply with ISO 9001 QMS standards, company QA standards and applicable contractual standards.
- Perform analysis and identify trends in the review of performance standards, work instructions, and policies and procedures; and recommend Opportunities for Improvement and Corrective and Preventative Action plans when necessary.
- Ensure that established performance standards, sampling and statistical process control procedures are followed.
- Create, review and update formal procedures (ISO documents).
- Train staff for the purpose of achieving and maintaining Quality Assurance goals.
- Coordinate and perform ISO based internal audits.
- Develop and maintain reports based on audit findings.
- Develop and implement corrective and preventive action plans based on audit findings.
- Develop other routine and ad-hoc reports when necessary.
- Develop updates and maintain quality manuals, and policies and procedures manuals.
- Associate Degree + 3 years of specialized experience.
- May have additional training or education in area of specialization.
- Develop solutions to a variety of problems of moderate scope & complexity.
- General application of concepts & principles.
- Contribute to the completion of organizational projects & goals.
- Frequent use and general knowledge of industry practices, techniques, and standards.
- Apply knowledge and skills to complete a wide range of tasks.
- Communicate on complex or sensitive issues or drafts such responses for supervisor or manager.
- Ability to strategically analyze disparate data sets and translate into tactical improvement, including strong computer/systems experience using databases, spreadsheets and graphics
- Strong decision-making and problem-solving skills required.
- Experience creating business process flows, process development/implementation and streamlining for improved efficiency;
- Ability perform in a fast-paced, deadline and detail-oriented work environment; must be able to successfully execute many complex tasks simultaneously
- Job Title Default
Job Title Default
Specialist - QA
Essential Duties and Responsibilities:
- Works on assignments that are routine in nature, with responsibilities easily learned on the job.
- Follow procedures and directions to assess the quality of service provided through monitoring incoming calls and other work types which focusing on the quality of customer service, accuracy of information provided, and adherence to established polices and procedures.
- Conduct call monitoring sessions to ensure workers are performing in accordance with established quality and performance standards.
- Provide feedback on call monitoring results.
- Evaluate recorded and/or transcribed interactions of a complex nature between the caller/chatter/correspondent and the worker, and provide appropriate context of ratings.
- High School diploma or equivalent with 0-1 years of experience.