Job Description
HealthSpire is a multi-carrier e-broker agency, directly responsible for utilizing digital channel to generate Individual Medicare business (e.g., MAPD, PDP, Med Supp., and Ancillary products) and provide client support through web-tele-advisors empowered with the latest data analytics. The Quality Analyst is responsible for measuring and monitoring the call center quality assurance program to ensure compliance with federal, state, carrier, and organizational guidelines. The role is to measure program effectiveness against established expectations set for HealthSpire Telesales Representatives. The position will directly report to HealthSpire’s Director of Quality and Performance.
Fundamental Components
Job Responsibilities :
Evaluates the quality and handling of calls and documents key trends/behaviors for management review.
Conducts audits to measure adherence and compliance within organizational/state and regulatory guidelines using designated scoring tool for all carriers.
Supports with training development and implementation for quality and performance programs.
Assists in compiling and tracking responses on agent complaints.
Makes recommendations on training needs, quality controls and procedures for continued improvement of quality and performance programs.
Involvement in developing, updating policies and procedures pertaining to business unit.
Supports with the day-to-day maintenance and operations of assigned functional unit.
Other duties as assigned
Accountabilities
Meeting organizational thresholds on quality assurance program.
Refinement of quality performance program and trainings to support business objectives.
Meeting compliance for all state, federal, carrier and internal programs.
Identify compliance risks within organization.
Background Experience
Must Have:
1 to 2 years Medicare call center experience or 4-year college degree with experience within Quality Assurance or Quality Improvement.
Active use of computer for carrying out daily job activities
Excellent communication and listening skills
Self-starter with positive attitude and ability to multi-task
Adoptable to high pressure, achievement-oriented environment
Drive to build and support an effective quality assurance program
Attention to detail and accuracy
High level of computer proficiency including, but not limited to, Microsoft Office package
Preferred:
Education
Bachelor's degree or equivalent experience
Percent of Travel Required
0 - 10%
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.