Call Quality Professional 2

Description

The Call Quality Professional 2 monitors and evaluates the quality of inbound and/or outbound customer service calls, call documentation, processes and the productivity of Calls Quality Professional 1 associates. Responsible for identifying and documenting gaps as well as recommending business solutions to drive improved quality and performance outcomes. The Call Quality Professional 2 work assignments require self-initiation, strong business focus and are of moderate to high complexity. Evaluates call recordings, documentation and productivity to assess appropriate process adherence in order to mitigate compliance and patient safety risks associated with external audit reviews. Responsible for driving accuracy and quality assurance, compliance to all established policies and procedures, and sound documentation for all activities. Serve as a subject matter expert to drive project improvement and serve as an associate advocate by supporting their content knowledge and sharing call management best practices. The Call Quality Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Call Quality Professional 2 provides information to assist in the feedback and formal education process of individuals on the phone and under the quality team alignment. May assist in the development of monitoring and updating standards based on business needs. Is expected to act as subject matter expert. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Responsible for supporting a forward thinking and professional culture within the organization.  Makes decisions regarding own work approach/priorities, and periodically communicates progress. Follows established guidelines/procedures. Helps with the overseeing of quality activities, in conjunction with the Quality supervisor, providing live support to the Quality team, sharing best practices, and supporting with content knowledge development. Assists with calibrating cases for the quality team, in order to gather data and identify root cause of trends to help with closing business gaps. The Call Quality Professional 2 provides support in the initiation of documenting auditing process, as well as keeping current processes up to date. Helps coordinating the assignment and monitoring of all tasks assigned.

The Call Quality Professional 2 will support core business internal and external audit activities, and must have the ability to work independently, with limited required direction and guidance. In addition, the associate must possess good analytical skills, ability to challenge the status quo to make recommendations and strong attention detail and tenacity.

               

Required Qualifications

• HS Diploma
• Experience with prioritizing and balancing multiple responsibilities and projects
• Experience working within a Healthcare environment and/or Quality Assurance.
• Documentation and call auditing experience to identify process improvement to promote efficiency in meeting compliance measures.
• Proficiency in Microsoft Office Programs, e.g. Word, PowerPoint, Excel, etc
• Critical thinking skills
• Excellent Communication Skills (written and verbal)
• Ability to work in a fast paced environment
• Ability to handle multiple tasks and deadlines within short notice with strong attention to detail
• Ability to research, analyze and proofread data
• Ability to interpret documentation and guidelines with complexed or limited details

Preferred Qualifications

• Associate's degree or higher
• Medicare/Medicaid experience
• Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance.  If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing
• Proficiency in Visio, Microsoft Access and PowerPoint
• One or more years of leadership skills experience

Additional Information

• Schedule: Monday to Friday from 8 am to 8 pm. Schedule is subject to change based on business needs (Voluntary/Mandatory OT – Including Weekends)
• Training: Remotely due to COVID-19 emergency
  • External Candidates:  10  weeks in New Hire Training
    • 5 weeks in Class Training
    • 5 weeks on the Job Training (taking calls)
  • Role Training – 4 weeks (Practice/Quality)
    • Internal Candidates (Member Service area): Straight to Role Training
    • External Candidates: Role Training  will start once the 10 weeks of New Hire Training is completed

Note: Based on business needs, the training can be extended.

• Work Location (Address): This permanent job is working from Home temporary due to Covid 19 emergency.
• ​Travel: 30%
• (FOR BILINGUAL CANDIDATES ONLY) Language Proficiency Testing: Any Humana associate who speaks with a member in a language other than Spanish and/or English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Excellent communication skills (both oral and written)

Scheduled Weekly Hours

40