Specialist-Quality MCC
Experience: Job Code: REQ-017046
Sagility
Bangalore
job Details
Job title
Specialist-Quality MCC
About Sagility
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.
Job title:
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: