Member Service Quality Analyst

SUMMARY

This role is dedicated to Member Services. This position works with the Lead Quality Analyst, internal team members, clinicians, pharmacies, and plan sponsors, including Member Service SOC audit processes. And other departments within the company to ensure our Member Service team's quality processes are tracked accurately and efficiently.

ROLES AND RESPONSIBILITIES

• Support MS quality monitoring program, ensuring every agent receives the monitors and feedback required and needed for improvement.
• Update agent report cards monthly with feedback.
• Review 90% of all Task cases for accuracy.
• Identify agents and plans for trends, including tracking of escalations.
• Schedule and conduct bi-weekly or as needed call collaborations.
• Recommend, implement, and monitor preventative and corrective actions to ensure that quality assurance standards are achieved.
• Collaborate with leaders to enhance quality assurance policies and procedures based on findings.
• Collaboration with all internal teams to support MS education and training needs.
• Have a patient-centric mindset and a high sense of urgency.
• Impeccable documentation and follow-up skills.

MINIMUM QUALIFICATIONS AND EDUCATION

• Self-starter with a strong attention to detail.
• Solid time management and follow-through.
• Ability to work effectively in a team environment.
• Intermediate skills in MS Word, Excel, Salesforce 
• Ability to communicate clearly, present complex information to internal team members and leaders
• Ability to organize and prioritize multiple deadlines and work independently, define problems as they arise, and work through them.
• Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique and/or immediate issues.

PREFERRED QUALIFICATIONS

• Experience 2+ years in Healthcare or pharmaceutical industry experience.
• Experience in quality inspection, auditing and testing.
• Excellent communication skills, both written and verbal
• Meticulous attention to detail
• Relevant training and/or certificates as a Quality Analyst

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk and hear and to use hands to finger, handle, or feel. The employee frequently is required to sit. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Seniority Level

Entry

Industry

Pharmaceutical Benefits Management

Employment Type

Full-time-Hourly-40 hours/week