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KEPRO (The Keystone Peer Review Organization)Harrisburg, PA
Remote
  • KEPRO is a rapidly growing national quality improvement and care management organization.
  • We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.
  • KEPRO is seeking resumes for a highly experienced professional.
  • Collaborate with the Chronology and Claim/Risk Management nursing staff to ensure production of quality reports within the HRSestablished deadlines.
  • Collaborate with the Administrative Assistant staff to ensure all tasks as assigned are completed timely and with attentiveness to detail.
  • Collaborate with the Medical Director to ensure quality and timeliness of Expert Medical Reviewer (EMR) reporting.
  • Assess and evaluate the daily work queue (Tickler) and adjust staffing schedules to ensure production of reports within the HRSestablished deadlines.
  • Assist the Operations Manager (Ops Mgr.) with monthly claim audit duties.
  • Assist the Ops Mgr. with monthly, quarterly, annual claim trend, and ad hoc reporting as contractually required.
  • In the absence of the Ops Mgr., serve as liaison between KEPRO and HRSA.
  • Attend and productively contribute to monthly KEPRO Operational/HRSA team meetings.
  • Participate in quarterly Local Quality Improvement Committee (LQIC) meetings contributing to process improvement, as necessary.
  • Review EMR timesheets and submit to Ops Mgr. for approval, as necessary.
  • The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
  • Knowledge, Skills, Abilities
  • Excellent verbal and written communication skills.
  • Strong analytical and interpretive skills.
  • Strong organizational and decision-making skills.
  • Computer proficiency in Microsoft Office and other software programs operating in a Windows environment.
  • (Excel, Word, Adobe, PPT)
  • 3-5 years of supervisory experience in a healthcare/legal office setting.
  • Workload management experience strongly preferred.
  • Previous experience writing Claim Management Recommendations Reports and Risk Management Recommendations/Quality Improvement Reports preferred.
  • Previous experience in review and analysis of medical data desired.
  • Mental and Physical Requirements
  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
  • Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job.
  • While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.
  • KEPRO offers challenging careers, excellent benefits and opportunities for advancement.
  • For consideration, please submit resume and cover letter with salary requirements.
  • Only those candidates identified for an interview will be contacted.
  • No Phone Calls Please.
  • Visit our website at www.
  • KEPRO.com for more information on the KEPRO Family of Companies.
  • EOE AA M/F/Vet/Disability
  • KEPRO is an Equal Opportunity Employer.
  • All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
  • Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
  • The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

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