The Operations Quality Assurance Associate I will evaluate work completed by Operations agents against program SOPs, WINs, business rules, and other program-related documents for adherence to expectations outlined in the documents.
The QA Associate I must be able to use objective decision-making and critical thinking skills to determine whether audited work meets internal and external expectations. The Operations Quality Assurance Associate I will be a subject matter expert for their respective assigned business unit(s) and will utilize analytical skills to analyze data, processes, and workflows to provide insightful, actionable coaching for the Operations Agents.
Responsibilities
What you will do:
Coach Operations agents (peer to peer) on areas of opportunity for improvement found during evaluations, collaborate with training for Operations agents (i.e., new hire, refresher, and nesting training)Performs and documents results of all quality assurance evaluations on all operational products and services, including (but not limited to) benefit verification cases, patient assistance cases, software support calls/emails, inbound calls from patients or health care providers, data entry, etc.Participates in internal, vendor, or client calibration meetings as required to address quality initiatives but does not lead themIdentifies and escalates critical quality issues appropriately to senior managementAssists with other QA-related functions and responsibilities as needed to meet department and company goalsAvailability to work occasional evening and/or weekend hours to meet company and departmental goals as the business need arisesAuditing work completed by Operations agentsSending feedback to Operations leadership on agent performanceAttending meetings, helping with data analysis, and other duties as assigned Qualifications
What we need from you:
Highschool or relevant experience1 – 3 years as a Case Manager, Benefit Verification Specialist, or Contact Center agent at ConnectiveRx, or equivalent experience in a similar role in another company, or 1 – 3 years of prior quality control experienceModerate Excel ability (data validation, data entry, tables, simple formulas) Experience with technical writing (e.g., SOPs, User Manuals, Work Instructions), typing, and PowerPoint ability.Knowledge Solid working knowledge of quality-orientated services such as accuracy management, performance metrics, customer experience/satisfaction, healthcare benefits, and SOP execution. Health Care Experience is required, specifically claim processing, contact center, benefit verification, or similar industry experience. Call Center and/or Claim Processing experience is a plus.Problem-solving, results-oriented, active listening, and high attention to detail. Monitor telephone calls and communications between The Customer and The Customer Care Center. A strong understanding of empathy across the Customer Care Center is required in all patient interactions. Ensure provision of exceptional customer service required in customer care case management engagement. Work in a matrix environment requiring strong collaboration skills. Options ApplyApplySubmit a ReferralRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Application FAQs
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