Posted Jul 13, 2026

Quality Assurance Representative II, Managed Care

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We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Valley Position Overview: Conducts performance and quality reviews/audits to promote completeness and accuracy, and/or to ensure customer receives quality service and appropriate follow-through communication. Incumbent is assigned more complex transactions, requiring considerable research and analysis to complete. Proactively recognizes and identifies problems associated with complex issues related to customer needs; contract language, fee schedules, code editor, etc. Leverages experience and resources to reach a solution. Provides feedback to leadership and shares observations, trends and data with team, making formal recommendations where appropriate. Assists in mentoring and collaborating with team members needing technical guidance. Serves as a resource to team or others. Job Description: EDUCATION: HS Diploma or General Education Diploma (GED) TYPICAL EXPERIENCE: 1 year of recent relevant experience. SKILLS AND KNOWLEDGE: Medical billing and claims processing Various medical insurance types Healthcare operations Electronic health record systems Understand basic medical insurance terminology including CPT and ICD-10 codes Demonstrated effective verbal and written communication skills and ability work effectively with others Time management and organization skills Ability to formulate recommendations Demonstrates analytical and critical thinking skills with the ability to reconcile data differences Ability to multi-task and prioritize work to meet timelines Demonstrates follow-through on issues Demonstrates proficiency with using Outlook, Word, Excel, PowerPoint or similar programs Able to perform basic math calculations Ability to read and interpret diagrams and standard workflow/processes Demonstrates ability to mentor and teach others to support the development of peers   Job Shift: Days Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: None Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $29.96 to $43.45 / hour. New Jersey, Washington Pay Range is $29.96 to $43.45 / hour. Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Virginia Pay Range is $26.97 to $39.11 / hour. Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, South Carolina, Tennessee, Utah Pay Range is $23.97 to $34.76 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.