QI Specialist II

This is a grade 13, rotational position based on candidate experience. Qualified applicants will have applicable technical SIU (Specialist Investigations Unit) Claims expertise.

Under direction, reviews and analyzes SIU investigations to determine compliance with claims handling standards. Assists and participates in calibration training, analysis of results, development of QI reporting and presentation of findings. Facilitates calibration of quality assurance team. Assists management in compiling and analyzing results and presenting findings to claims management. Participates in and/or facilitates smaller size operational RCPS events and provides support for implementation of improvements.

**This is a 2 year development program that has been designed to build and develop capabilities and professional acumen to prepare you for future roles at Liberty Mutual.

Responsibilities

• Under limited direction, conducts performance audits of claims files.
• Analyzes all aspects of investigations involving varying levels of complexity.
• Determine compliance with claims handling standards, policies and procedures as determined by calibration.
• Under limited direction, analyzes results and develops the necessary detail from audits conducted to assist the QI team in identifying the trends from an audit which, if corrected, would drive improvement.
• Accurately tracks and inputs audit findings into database.
• Participate in calibration with File Review team and the analysis of overall results.
• Under limited direction, assists in the preparation and leads presentation of results, conclusions and recommendations to field leadership on less complex claims.
• Assists with driving continuous improvements by providing feedback on audit process and tool changes that will result in a better product being delivered to the line of business.
• Performs other duties as assigned.