Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Position Summary
The Procedural Quality Associate will support the delivery and execution of business solutions within the Technology Enabled Services organization. The mission of this role is to propose and coordinate the implementation of solutions that enhance customer value and improve athena's operational efficiency. The Associate will serve as an expert in the healthcare RCM industry. Success in this position requires strong analytical thinking, superior attention to detail, and effective communication skills.
Essential Functions (Duties and Responsibilities)
70% Business Analysis and Process Improvement
- Use data analysis and qualitative evaluation to determine root causes of problems.
- Analyze trends to deliver clear and compelling data stories to stakeholders.
- Design solutions that prioritize automation, error prevention, and product enhancement over manual workflows.
- Gather and apply internal and external client feedback to drive decisions and improvement opportunities.
- Identify opportunities to expand client value by enhancing existing services or introducing new ones, leveraging knowledge of customer business needs.
- Design, develop, and deliver training programs for new hires, cross-training, and upskilling initiatives.
- Handle and resolve BPO clarifications and escalations on time, ensuring clear guidance and correct process understanding.
- Create, update, and simplify workflows, procedure manuals, and LMS courses based on recurring questions and quality trends.
- Plan and deliver training sessions (virtual and in-person) for BPO teams, focusing on correcting top errors and improving performance.
- Coordinate retraining, refresher courses, and follow-ups with BPO trainers to ensure all teams complete trainings within the required timelines.
- Track training effectiveness through feedback, QA improvements, and course completion rates, and make updates wherever needed.
- Maintain and publish updated documentation, store materials in SharePoint, and support teams with any training or process-related needs.
20% Project & Stakeholder Management
- Lead initiatives and projects that improve client and operational outcomes, serving as a subject matter expert.
- Develop project plans and initiative roadmaps, set stakeholder expectations, and proactively identify risks.
- Define success criteria to create transparency and visibility into process performance and improvement areas.
- Partner with internal and external stakeholders to remediate pain points and optimize desired outcomes.
- Foster collaboration among stakeholders to promote alignment, teamwork, and shared accountability in achieving quality outcomes.
10% Mentorship and Training
- Provide mentoring, support, and ongoing education for new hires and colleagues across Operations.
- Create role-specific content and collateral to enhance learning.
- Actively engage with team members, sharing knowledge and encouraging continuous learning.
Education & Experience Required
- Bachelor's degree or equivalent.
- 5-7 years of experience in the US Healthcare industry.
- Proven experience working with cross-functional groups and teams to achieve common goals.
- Strong background in communicating and presenting to stakeholders.
- Experience partnering with internal and external stakeholders to drive desired outcomes.
Knowledge & Skills
- In-depth knowledge of Healthcare Revenue Cycle Management (RCM), with expertise in Denial Management and Accounts Receivable (AR) Management.
- Solid understanding of ARM, audit tools, and quality check processes.
- Strong analytical and problem-solving skills.
- Excellent verbal and written communication skills with the ability to articulate actions taken and outline next steps clearly.
- Proficiency in MS Office applications.
