Quality Assurance Specialist

New England Sinai Hospital And Rehabilitation Center Phoenix , AZ 85002

Posted 2 weeks ago

The primary role of this position is to develop and follow Quality Monitoring Guidelines to provide a detailed description of the call quality performance requirements.# This role will be responsible to monitor and evaluate all lines of Call Center Operations business as well as monitor and evaluate calls for other departments taking calls from both members and/or providers. Oversee day to day operations set forth by the Department Management: Call Center Operations is committed to the delivery of quality services to its members and providers through the telephone system.# Monitoring of all phone representatives for all lines of business a minimum of 3 calls per month (may vary depending on line of business) ensuring adherence to contractual and Health Choice guidelines, and facilitate cross-training for increased responsiveness and departmental efficiency Complete electronic monitor forms on each call, record and communicate monitor results to phone representative Report results to management team Partner with department trainers to enhance training materials and develop ongoing training pertaining to quality assurance Review and access usage of correct action codes, and appropriate documentation in delivery systems (MedMC, Care Radius etc) Meet with Department Management on a regular basis to assess departmental operation and activities Complete and deliver any quality reports to the respective lines of business Ensure confidentiality and not release any information except to persons authorized by Health Choice or as required by law (URAC, v7.1, CORE 16b). Conduct #spot# monitoring on an as needed basis Conduct #side by side# monitoring on an as needed basis Any other activities as directed by department Leadership # #

Knowledge:
############ Proper customer service technique

Microsoft office


; Word, Excel Prefer Bilingual in Spanish



Skills:


Bilingual (English and Spanish) preferred Computer experience necessary Effective time management and organizational skills Effective interpersonal and communication skills Use of a multi-line phone


Abilities:


################# Ability to handle upset members Able to handle fast paced high stress situations Complete tasks with little supervision Ability to lead others Ability to think analytically and make independent decisions Ability to manage large workload Ability to maintain a positive work environment for employees Ability to maintain positive work relationships Handle multiple and changing priorities at a fast pace Work cooperatively, positively, and collaboratively in an interdisciplinary team Work respectfully and positively with members and providers Ability to manage multiple projects and prioritize work tasks to adhere to deadlines and identified time frames


Education:


High School Diploma or G.E.D. preferred Some college preferred in business or health care desired Experience: At least two (2) years customer service experience At least two (2) years Medicaid and Medicare experience, preferably AHCCCS. At least one (1) year call center environment preferred At least one (1) year experience as a trainer preferred


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Quality Assurance Specialist

Covetrus

Posted 1 week ago

VIEW JOBS 4/17/2019 12:00:00 AM 2019-07-16T00:00 Quality Assurance Specialist Covetrus is a global animal-health technology and services company dedicated to empowering veterinary practice partners to drive improved health and financial outcomes. We're bringing together products, services, and technology into a single platform that connects our customers to the solutions and insights they need to work best. Our passion for the well-being of animals and those who care for them drives us to advance the world of veterinary medicine. Covetrus is headquartered in Portland, Maine, with more than 5,000 employees, serving over 100,000 customers around the globe. POSITION SUMMARY This position will work under the supervision of the Quality Assurance Officer helping to perform all quality functions. TRAINING REQUIREMENTS * General Company training requirements during orientation: Hazardous substance, Company policies, Human Resources Manual * Annual General Company training requirements * SOPs * Training in cGMP ESSENTIAL DUTIES AND RESPONSIBILITIES * Keeps current on cGMP requirements for the 503B Outsourcing Facility * Change control process * Works on quality related events, customer complaints and ADEs determining a root cause and corrective action * Follows up on corrective actions * Internal audits * A team member for external audits * Assists with recalls * Material control, inspection, quarantine and release * Checks equipment cleaning, service, and maintenance * Inspects incoming products * Puts products into quarantine * Inspects products used in batch production * Retain sample inspection * Stays current on legal and regulatory environment for compounding * Identifying and solving problems * Assists the microbiologist with sampling KNOWLEDGE, SKILLS AND ABILITIES * Document Control * Root Cause Analysis * Adverse Drug Event Reporting * Internal and External Audits * Customer Complaints * Medication Errors * Record keeping * Material control and qualification * CAPAs- Corrective and Preventive Action plans * Must possess a professional appearance * Strong verbal and written communication skills * Strong organizational and documentation skills * Problem solving skills EDUCATION AND/OR EXPERIENCE * Experience with quality systems and document control * Understanding of USP 795 and 797, cGMP, and pharmacy regulations preferred * 1 year previous experience with quality systems preferred PHYSICAL DEMANDS AND WORK ENVIRONMENT The physical demands and work environment are characteristic of those found in a typical laboratory environment. There is a potential exposure to chemicals used in the preparation of compounds and cleaning agents used in the facility. This position will require the ability to sit in an office or stand for an extended period of time. It also will require enough physical dexterity and fine motor skills to type, manipulate syringes, and work with delicate equipment and devices. The physical demands and work environment require enough flexibility and strength to undergo donning sterile garb from head to foot with all skin covered and ability to pass medical clearance to wear an OSHA 95 respiratory mask. Some travel may be required. Reasonable accommodations may be made for individuals with disabilities to perform essential functions. * Manual dexterity * Adequate vision for tasks assigned Covetrus is an equal opportunity/affirmative action employer. It does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated with undue hardship, sex, sexual orientation, age, citizenship, marital or veteran status, or any other legally protected status. Covetrus Phoenix AZ

Quality Assurance Specialist

New England Sinai Hospital And Rehabilitation Center