Jay Almonte
Quality Assurance Professional
Hire this person
Send a job offer directly to this candidate
About
Highly organized and dependable Quality Assurance professional with extensive experience in healthcare operations, compliance, and team leadership. Skilled in quality monitoring, staff supervision, and process improvement with a strong commitment to accuracy, accountability, and continual development.
Experience
Quality Assurance Supervisor - C-YES / Children and Youth Evaluation Services – MAXIMUS - New York, NY
(2024-05)
- Supervise two Quality Assurance teams: QA Nurse Specialists and QA Coordinators, ensuring all QA program tasks are completed accurately and on time.
- Oversee daily operations of the QA department, maintaining compliance with procedures and standards.
- Lead meetings and individual coaching sessions to monitor performance and professional development.
- Identify improvement opportunities and implement corrective actions and staff training.
- Ensure adherence to best practices across QA functions, including call monitoring, case reviews, and data reporting.
- Collaborate with management to achieve departmental goals and enhance workflow efficiency.
- Foster a culture of accountability, learning, and excellence across both QA teams.
Quality Assurance Coordinator - C-YES / Children and Youth Evaluation Services – MAXIMUS - New York, NY
(2021-11 - 2024-05)
- Reviewed case files for completeness, accuracy, and consistency across workflows.
- Developed and completed reports tracking and trending quality outcomes.
- Performed quality checks on consumer notices to ensure compliance with standards.
- Created and facilitated orientation and in-service training for QA staff.
- Conducted call monitoring and provided feedback to support quality improvement.
- Supported project goals and collaborated with management to ensure effective QA monitoring.
Quality Control Administrator - New York State of Health / MAXIMUS - New York, NY
(2018-05 - 2021-10)
- Conducted quality reviews for Call Center and Eligibility & Enrollment staff.
- Identified and escalated issues that did not meet compliance requirements.
- Participated in calibration sessions and ensured alignment of quality metrics.
- Maintained up-to-date knowledge of policies, procedures, and system changes.
Consumer Service Specialist III - New York State of Health / MAXIMUS - New York, NY
(2014-04 - 2018-05)
- Assisted consumers with health coverage applications via the NYSOH marketplace.
- Educated consumers on Medicaid, Child Health Plus, and Qualified Health Plans.
- Ensured HIPAA compliance while delivering excellent customer service.
Education
Associate's Degree - Health Services Administration
High School Equivalence Certificate (2008-02)
