Full-Time Lead Quality Associate

• Quality Auditor would be responsible for the entire quality assurance process; from sample selection to conducting audits, performing error RCA and providing relevant feedback to associates.
• Auditor would ensure correctness and completeness of cases and compliance with applicable regulatory requirements.
• Auditor would also be responsible for reporting and tracking on accuracy SLAs and KPIs.
• Conduct quality monitoring reviews to include documentation of processes and call scoring in relation to cases reviewed
• Assist in developing and implementing quality management programs and initiatives.
• Complete RCA for all the critical errors identified.
• Ensure that performance standards are measured and uniformly for the clinical review team.
• Conduct coaching sessions with team in regards to improvements sessions that are needed.
• Conduct quality assurance training as needed and facilitate or participate in weekly/monthly calibration sessions.
• Escalate patterns of serious performance issues as necessary.

• Has minimum of 1-2 years of experience dealing with customers, providers and /or members via the telephone.
• Has a previous Quality Assurance and/or work experience.
• Prior experience in Dental Practice Services is a plus.
• Excellent verbal/written communication skills and presentation skills, including the ability to handle interactions with facility personnel, providers, members, and various internal departments in a professional manner.
• Be a highly motivated individual that can work effectively, independently and meet deadlines in an atmosphere of multiple projects and shifting priorities.
• Possess effective analytical/problem solving skills.
• Ability to use PC-based word-processing, database, and spreadsheet• Possess extensive knowledge of medical terminology and anatomy.
• Subject matter expert on all contracts maintained by Assessment unit.
• Ability to speak English fluently is preferred

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