Professional, Care Center Quality Assurance
Reviews and facilitates general quality overview and improvements in all areas of Customer Care Center (CCC) and acts as support in training, employee development, and process improvements. Responsibilities include: Facilitates Customer Care Center Call Coaching (Call Quality Review) program. Includes oversight of the applicable tasks including call monitoring, call coach development, standards implementation and review, quality training and feedback, performance tracking, and communication geared towards overall employee development, with the goal of ongoing and sustained improvement in service quality levels per both internal and external standards and business requirements. Identifies and implements process improvement initiatives, both at a departmental and corporate level, to increase operational efficiency and overall effectiveness of CCC operations and workflows. Performs statistical analysis to review opportunities for process and workflow improvement opportunities and implementation of project plans to facilitate improvements. Coordinates training as of a result of involvement in department related corporate projects. Participates in additional Customer Care Center training initiatives, including testing and implementing new technology. Oversees and coordinates MVP HIPAA standards including employee training and development, policy and process review and implementation, HIPAA compliance review, and acting as the HIPAA subject matter expert. Acts as a primary Quality Assurance reviewer for departmental initiatives including one call resolution and other departmental standards to insure proper auditing controls are in place and adhered to on a consistent basis. Assists department in handling member concerns, issues, and complaints, and may include direct member contact and issue resolution, as well as extensive interaction with other MVP departments. Is a liaison for MVP CCC and MVP Complaints and Appeals departments including complaints/appeals review to insure staff complies with MVP corporate standards as well as State and Federal regulatory requirements. Oversees and participates in department’s correspondence process including correspondence development and procedural development. Conducts audits to insure compliance with procedural and quality standards. Includes communication with outside contacts including NYS Department of the Attorney General, as well as compliance for required regulatory Managed Care Requests. Manages tasks including operational objectives, task designation, provides input into employee performance evaluations and assessments, and daily operations. Assists department in handling member concerns, issues, and complaints, and may include direct member contact and issue resolution, as well as extensive interaction with MVP departments. Performs other duties as required.
Assoc. degree Business/Management related field or two additional years of equivalent work experience may be considered.
Minimum 3 – 5 years related experience required.
Previous customer service leadership experience preferred
• Excellent personnel and training management skills;
• Excellent written and verbal skills; proven organizational and analytical skills;
• Attention to detail and quality service
• Microsoft Office (Excel, Word, PowerPoint, Access)
Must be bilingual - English/Spanish
• Strong working knowledge of Facets and Macess.
- Job Family Customer Service
- Pay Type Salary
- Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America