2 answers
2 answers
Updated
Nicole’s Answer
Good afternoon Abby. My day to day consist of monitoring and recognizing fraud, waste, and abuse among the providers in our vision network. I also conduct triennial audits to ensure that our members are receiving great service from our providers. Educating the providers on best practices ensures that the members who seek services get the very best we can offer with regards to their eyes.
Updated
Andrew’s Answer
Good afternoon. I review policies and procedures of departments and then develop a Quality Assurance testing program to ensure all risks associated with the department are being properly managed and controlled. It is something different and new every day. Based on the results of my testing, I will submit possibly enhancements to the process to ensure better management of the process. And, since the testing usually involves recreating what the department does, I am also able to come up with ideas to make the process better and/or quicker.