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Professional, Care Center Quality Assurance

Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #499
Tuesday, March 17, 2020
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people with diverse backgrounds and experience to make health insurance more convenient, more supportive, and more personal. The question we ask many times each day is: “how can we help you?”, which speaks to a philosophy that sets us apart as a health insurance company. The customer care staff who work with our members and health care providers make a positive difference in peoples’ lives. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.


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.

 

POSITION QUALIFICATIONS

 

Minimum Education:

Assoc. degree Business/Management related field or two additional years of equivalent work experience may  be considered.

 

Minimum Experience:

Minimum 3 5 years related experience required.

Previous customer service leadership experience preferred

 

Required Skills:

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 


Preferred  Skills:

Strong  working knowledge of Facets and Macess.

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

Other details

  • Job Family Customer Service
  • Pay Type Salary
  • Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America