Quality Assurance Analyst - HRSN

Job Summary Quality Assurance Analyst – HRSN. This position provides timely and accurate quality assurance, administrative, and analytical support for CareOregon’s internal Rent Assistance team and the Health-Related Social Needs (HRSN) benefit. The role ensures that member benefit allocations and payments are accurate, timely, and compliant with applicable regulatory, contractual, and organizational requirements. This is a hybrid position with the expectation to come to the downtown Portland office 1x/week, located in Portland Metro. Estimated hiring range: $66,690.00 – $81,510.00. Bonus target: 5% annual. Essential Responsibilities Conduct timely and accurate quality assurance reviews of member benefit allocations prior to payment, ensuring alignment with state and federal regulations and CareOregon policies. Review supporting documentation and system data to validate eligibility, benefit limits, accuracy of calculations, and appropriateness of payment amounts. Identify trends, patterns, and root causes of errors; proactively recommend corrective actions to improve quality, consistency, and productivity. Research claim, invoice, enrollment, and benefit processing issues to determine source, contributing factors, and appropriate resolution, escalating issues as needed. Collaborate with the Rent Assistance team to reduce rework by clarifying requirements, identifying gaps in documentation, and recommending process or workflow improvements. Develop, maintain, and distribute summary-level quality assurance and performance reports for leadership and the Oregon Health Authority (OHA). Analyze data and quality review results to identify improvement opportunities, compliance risks, and training needs. Track corrective actions and outcomes to assess effectiveness of improvement efforts over time. Support audits, inquiries, and data requests by preparing accurate documentation and responsive analyses. Support the development and delivery of training materials, job aids, and guidance to proactively address quality trends, common errors, and policy updates. Partner with management and cross‑functional teams to ensure quality assurance reviews remain effective, relevant, and aligned with organizational needs. Participate in meetings and workgroups related to HRSN benefits, rent assistance operations, and quality improvement initiatives. Perform accurate and timely data entry and accounting‑related support, including reviewing invoices, ledgers, rental statements, and utility bills to determine eligible reimbursement or payment amounts in accordance with benefit policies and procedures. Ensure all documentation is complete, properly stored, and accessible for reporting, audit, and compliance purposes. Utilize technology systems and databases effectively for documentation, quality tracking, reporting, and communication. Use standard Microsoft Office applications (Excel, Word, PowerPoint, Outlook), SharePoint, Workday, Unite Us, and other applicable systems to create and maintain documents, spreadsheets, charts, graphs, and reports. Independently manage special projects or ad hoc assignments, including process reviews, data clean‑up efforts, and pilot initiatives. Perform work in alignment with the organization’s mission, vision and values. Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open‑mindedness, cultural awareness, compassion and respect for all individuals. Strive to meet annual business goals in support of the organization’s strategic goals. Adhere to the organization’s policies, procedures and other relevant compliance needs. Perform other duties as needed. Experience and Education Required Minimum 2 years’ experience in data quality assurance, including data entry, tracking, and reporting. Minimum 4 years’ experience in Medicaid, health plan operations, or managed care organizations. Experience with regulation and applying rules to a process. Preferred experience in managed care. Experience in quality assurance or improvement. Experience collaborating on or managing projects. Housing familiarity. Knowledge, Skills and Abilities Required Working knowledge of Microsoft Office system, including intermediate Excel skills. Knowledge of basic medical terminology. Knowledge of care management platforms and experience with documenting in care management or similar platform. Knowledge and experience with Federal, State and Local regulations and HIPAA privacy rules and regulations. Strong organizational skills. Attention to detail. Familiarity with Medicaid claims billing and coding. Computer skills and ability to learn new technology quickly. Ability to use good judgment, personal initiative and discretion to perform work with particular attention to detail. Ability to effectively interact with individuals at all levels internal and external to the organization. Good written and verbal communication skills. Good customer service skills. Basic teamwork skills. Ability to manage multiple tasks. Ability to work in a fast‑paced environment. Ability to work effectively with diverse individuals and groups. Ability to learn, focus, understand, and evaluate information and determine appropriate actions. Ability to accept direction and feedback, as well as tolerate and manage stress. Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours a day. Ability to hear and speak clearly for at least 3–6 hours a day. Working Conditions Work Environment: Indoor/Office. No community or facility security exposure. No member/patient facing. Potential physical and ergonomic hazards may be present. Travel: Occasional required or optional travel outside of the workplace may be necessary. Work Location: Work from home. Schedule: Monday – Friday, 8:00am – 5:00pm. Benefits CareOregon offers a comprehensive benefits package for benefits‑eligible employees beginning on the first of the month after the start date. Benefits include medical, dental, vision, life, AD&D, and disability insurance; health savings account; flexible spending account; lifestyle spending account; employee assistance program; wellness program; discounts; and supplemental benefits such as voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre‑tax parking, pet insurance, and a 529 College Savings plan. A strong retirement plan with employer contributions is also available. PTO and paid state sick time accrue based on hours worked. Additional paid holidays, volunteer time, jury duty, and bereavement leave are offered when eligible. Equal Opportunity Employer CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status, or disability. The organization will provide reasonable accommodation for qualified applicants or employees with disabilities unless it would impose undue hardship. Veterans are encouraged to apply. CareOregon sponsors candidates from diverse backgrounds to promote a culture of equity and inclusion. #J-18808-Ljbffr