Quality Improvement Representative

Posted:
11/27/2024, 1:10:32 AM

Location(s):
New York, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Customer Success & Support

Workplace Type:
Hybrid

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Bilingual in Russian (Preferred)

Position Purpose: The Quality Improvement Representative assesses the skills of new and existing staff to identify gaps and recommend training; acts as a subject matter expert for all systems to provide on-the-job support for Retention staff; uses workforce optimization tools and qualitative standards to measure and track critical performance areas.

  • Monitor and conduct quality control on Retention staff inbound and outbound calls.
  • Ensure the Retention staff understands and adheres to standard operating procedures and quality assurance standards; monitor the accuracy of the information provided by the Retention Representative to the member; determine if Retention Representative is focused on the member’s concern throughout call, is courteous, and exhibits skills to deliver effective and sufficient service to the member; identify and document obstacles in the call handling process and suggest ways to prevent or overcome those obstacles.
  • Effectively assess the skills of new and existing staff to identify gaps and recommend training to support development.
  • Identify the Retention Representatives and Team Leads requiring additional training to improve performance. Partner with the Retention management team to develop individual developmental plans.
  • Act as a subject matter expert to provide on-the-job support for Retention Team; perform additional administrative and operational duties to ensure consistent service levels despite changing departmental needs.

Education/Experience: AA/AS- Associates Degree or a minimum of 2 years call center experience, required. BA/BS-Bachelor’s Degree or 6 years of call center experience, preferred. Three or more years of Customer Service experience.

One to two years Supervisory experience, preferred. Proficiency in Microsoft Office: Excel, Word, Access; Lotus Notes; Internet. Proficiency in one or more languages other than English. Knowledge of Government sponsored health insurance programs. Strong working knowledge of Managed Care and Health Insurance concepts and regulations.
Understands the appropriate etiquette and demands of a call center environment and is familiar with the standard call handling metrics.

Bilingual in Russian (Preferred)

Pay Range: $22.36 - $38.07 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act