Quality Auditor

WellCare
Tampa, FL Full Time
POSTED ON 3/7/2020 CLOSED ON 3/17/2020

What are the responsibilities and job description for the Quality Auditor position at WellCare?

At WellCare, we are a passionate team with a strong mission and a focused purpose: to serve our members and communities in which they live while helping them live better, healthier lives. Our culture is one of empowerment, teamwork and commitment as we all work together to deliver cost-effective solutions that create positive outcomes for our members. Join us a career that inspires passion and purpose across all levels and disciplines within our award-winning organization.

Perform quality reviews, Random Shopper Test Calls and Root Cause Analysis on Operational areas to ensure accuracy of departmental processes and identify, when needed, process improvement opportunities.
Essential Functions:
  • Conduct daily quality reviews of operations department processes (via random shopper test calls, agent evaluations, root cause analysis of identified opportunities, and overall analysis of customer service call handling)
  • Process/Document the creation and enhancement based on identified opportunities
  • Track and maintain quality results for appropriate distribution
  • Communicate audit results in a structured report format
  • Identify and communicate process improvement opportunities across Operational areas
  • Assist with special projects and other duties as assigned

Education: High School Diploma required; College degree preferred
Experience: Minimum 2 years Customer Service experience
Special Skills (e.g. 2nd language):
Knowledge at a level usually associated with a college degree and 5 years of direct related experience
Ability to multitask (as necessary)
Ability to work in a fast paced environment with changing priorities
Ability to remain calm under pressure
Ability to sit for extended periods of time
Technical Skills/Requirements:
Demonstrated technical expertise in performing quality reviews along with analysis of results
Knowledge of MS Outlook sufficient to communicate with internal and external contacts
Knowledge of MS Word sufficient to create simple documents such as memos and reports
Knowledge of MS Excel sufficient to create simple spreadsheets containing formatting, totals and averages, enter data into spreadsheets
Knowledge of MS PowerPoint sufficient to create simple presentations
Knowledge of additional software programs as necessary

About us
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

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