Quality Analyst

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Job Description - Quality Analyst

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.

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:

Quality Analyst

Job Description:

DUTIES & RESPONSIBILITIES:

Performance Management:

  • Designs and publishes quantitative and qualitative reports to establish patterns and trends of quality performance, errors and improvements.
  • Works with Operations and Training Team to provide insights to address any issues that needs refresher trainings.
  • Responsible in doing objective evaluation of agent/business interaction points with customers either via Web, voice, e-mail, white mail.
  • Works with operations and training team in keeping compliance to the processes set by Sagility or client.
  • Facilitate calibration sessions with the client, Operations and Training Team.
  • Conducts refresher training in coordination first either with Client, Operations or Training Team.
  • Conducts product specific coaching sessions with the agents to address process and product related challenges.
  • Coordinates with training Team before sending program related updates.
  • Commits phone time and/or specimen management based on capacity requirement, mandated by Operations, high call volume and low agent headcount.

Process Improvement:

  • Offers suggestions for continuous improvement of processes and systems.
  • Provides assistance in the implementation of any projects and initiatives.

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) and Health Information Technology for Economic and Clinical Health Act (HITECH) as appropriate

COMPETENCY REQUIREMENTS:

With Basic Competency Level in ff.:

1. Team player

2. Ability to understand and interpret policy provisions

3. Product knowledge

4. Typing Skills

5.Problem Solving Skills

6. With advance knowledge on Microsoft Applications such as: Outlook, Excel, Word and PowerPoint

With Moderate Competency Level in ff.:

1. US Healthcare Delivery System

2. Philippine Healthcare Delivery System

3. Clinical Skills

4. US Healthcare 101

5. Customer Service orientation

6. Computer literate

7. Interpersonal Skills

8. Sense of Urgency

9. Passion for Excellence

OTHER REQUIREMENTS:

Reports to:

Quality Team Leader or BE Manager

Education:

Minimum educational requirement is at least a graduate of Senior High School or 2 years in college of any course ( no failing grades applicable only for external applicants or hires ). If a graduate of any 4-yr College Degree is plus.

Work Experience:

Preferably with 1 ? 2 years of customer service experience. If previous experience is from a Healthcare account it?s a plus.

Certificates, Licenses, Registrations:

If an Active Philippines Certified Registered Nurse (RN) is a plus.

Work environment:

The work environment is professional office workplace. Business casual attire

Physical demands:

Requires evening or graveyard work

May require overtime, weekend, or holiday work depending on business needs.

Work demands:

  • Reports to office but may require work at home set-up:
  • The work environment consists of designated work area at home;
  • Home internet service provider with minimum of 10-15 mbps upload/download speed
  • Smart mobile phone compatible with UEM Client usage
  • Able to establish and implement quality information security policies assigned to him/her.
  • Cascade and implement procedures to protect classified information.
  • Report information security related incidents without any delay to the right authority. Example: All information-related incidents, losses, weaknesses and software/hardware malfunctions, breaches of confidentiality.
  • Actively participates during training, orientation and awareness programs pertaining to QISMS.

Location:

Quezon City, Bridgetowne ZetaPhilippines #J-18808-Ljbffr
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