Job description
SUMMARY
This role is dedicated to Member Services. This position works with internal team members, clinicians, pharmacies, plan sponsors, including Member Service SOC audit processes. and other departments within the company to make sure our Member Service team is tracked accurately and efficiently.
ROLES AND RESPONSIBILITIES
· Support MS quality monitoring program, ensuring every agent receives the monitors and feedback required and needed for improvement.
· Review 90% of all Task cases for accuracy.
· Identify agent and plans for trends including tracking of escalations.
· Schedule and Conduct all call collaborations bi-weekly or as needed.
· Recommend, implement and monitor preventative and corrective actions to ensure that quality assurance standards are achieved
· Collaborate with leaders based on findings to enhance quality assurance policies and procedures
· Collaboration with all internal teams to support MS education and training needs.
· Have a patient centric mindset and a high sense of urgency.
· Impeccable documentation and follow up skills.
MINIMUM QUALIFICATIONS AND EDUCATION
· Self-starter with a strong attention to detail.
· Solid time management and follow through.
· Ability to work effectively in a team environment
· Intermediate skills in MS Word, Excel, Salesforce
· Ability to communicate clearly, present complex information to internal team members and leaders
· Ability to organize and prioritize multiple deadlines and work independently, define problems as they arise, and work through them.
· Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique and/or immediate issues.
PREFERRED QUALIFICATIONS
· Experience 1+ years in Healthcare or pharmaceutical industry experience.
· Experience in quality inspection, auditing and testing
· Excellent communication skills, both written and verbal
· Meticulous attention to detail
· Relevant training and/or certificates as a Quality Analyst
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk and hear and to use hands to finger, handle, or feel. The employee frequently is required to sit. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Seniority Level
Entry
Industry
Pharmaceutical Benefits Management
Employment Type
Full-time-Hourly-40 hours/week
Job Type: Full-time
Pay: Up to $24.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Experience level:
- 1 year
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Healthcare/Pharmaceutical: 1 year (Required)
Work Location: Remote
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