Summary of Position

Responsible for assessing the quality of performance of employees who handle calls from our existing and potential members, providers, patients and customers.
Provide full evaluation and feedback on customer service skills and call handling to employees throughout the Call Centers across the Enterprise.
Ensure ongoing compliance with quality and industry regulatory requirements as well as identifying and tracking performance trends and making recommendations to employees for improvement.

Principal Accountabilities

Audit staff and delegated entities to identify and investigate trends in audit results, identify root causes, report accuracy and compliance, analyze impacts, and generate recommendations to address.
Conduct analysis in a professional and confidential manner with a focus on the three critical quality components: technical accuracy, soft skills, and proper routing, resolution and documentation.
Perform research and collaborate on projects as needed.
Track issues in the quality monitoring systems or tools and analyze the results.
Develop, continue to update, and deliver Quality Analysis training program for new team members.
Deliver new hire auditing overview and orientation programs.
Remain current with updates to industry standards regarding metrics relative to audit best practices, reporting trends and industry standard changes.
Provide overviews in a team environment to educate the staff on audit results and trends; discuss team results on a regular basis.
Perform other job-related duties as directed or required.

Qualifications

Education, Training, Licenses, Certifications

Bachelor's Degree required; additional experience/specialized training may be considered in lieu of educational requirements

Relevant Work Experience, Knowledge, Skills, and Abilities

2 - 3+ years' relevant, professional work experience required
2 + years' experience with Quality auditing required
Customer Service / Call Center experience preferred
Excellent analytical and problem-solving skills required
Thorough understanding of systems and policies and procedures required
Proficient with MS Office (Word, Excel, Outlook, Power Point) required
Strong communication skills (verbal, written, presentation, interpersonal) required
Attention to detail; organizational and time management skills; analytical and problem-solving skills required
Proven ability to successfully manage multiple tasks/projects with competing priorities and deadlines required
Ability to adapt to changes in workflow, projects, tasks, environments, procedures, etc. required

Additional Information

Quality Analyst

Nearby locations