Operations-Quality Associate

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.Operation Support

Job title:Operations-Quality Associate

Job Description:

DUTIES & RESPONSIBILITIES:

Performance Management:

Responsible for monitoring in an objective fashion all customer contact points. (Web, voice, e-mail, white mail.)

Responsible for reporting all behavior that does not conform to the quality standards set by the company and the account management.

Designs and implements reports to establish patterns and trends of quality issues as they may arise.

Provides quantifiable data to all quality judgments that are made.

Works with operations as an auditor as well as regulator of quality issues.

Works with Training and Operations to provide trend reports to address any issues that need refresher training.

Conducts calibration session with the client and with Operations.

Conducts product specific coaching sessions with the agents regarding trends and quality.

Responsible in releasing updates and training flashes to Operations and Training group.

Handles incoming calls and/ or escalated calls and meets telephone productivity standards.

Follows other tasks and/ or offline tasks assigned by his Training/ Quality Managers.

Process Improvement:

Offers suggestion for continuous improvement of processes and systems.

General Safety and Security

Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS)

Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.

Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act and URAC

COMPETENCY REQUIREMENTS:

With Basic Competency Level in the ff.:

Excellent interpersonal skills Ability to understand and interpret policy provisions. Product knowledge Typing Skills Problem Solving Skills

With Moderate Competency Level in the ff.:

US Healthcare Delivery System Philippine Healthcare Delivery System Clinical Skills US Healthcare 101 Customer Service orientation Computer literate Interpersonal Skills Sense of Urgency Passion for Excellence

OTHER REQUIREMENTS:

Reports to:

Quality Assurance Supervisor/Lead

Education and/or Experience:

Preferably an Active Philippines Certified Registered Nurse (RN) with minimum 2 years post education clinical experience.

Or Graduate of any 4-year course, preferably of a life-science course with 1 – 2 years of relevant work experience gained in a customer service-oriented environment.

Certificates, Licenses, Registrations:

Active Philippine Certified Registered Nurse (RN) and country mandated license requirements.

For USRN Lines of Businesses: Unrestricted US Certified Registered Nurse (USRN) license, state license requirements, CEUs and state mandate requirements.

Language Skills:

English, additional language a plus. Strong communication and interpersonal skills.

Computer Skills:

MS Office.

Work environment:

The work environment is professional, office.

Business casual attire.

Physical demands:

May require weekend, evening or shifting work schedule.

Location:Quezon City, Bridgetowne ZetaPhilippines

REQ-005086