Specialist-Quality MCC

3 days ago

Bengaluru, Karnataka, India Sagility Full time ₹ 4,00,000 - ₹ 8,00,000 per year
About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Specialist-Quality MCC

Job Description:

DUTIES & RESPONSIBILITIES:

Performance Management:

  • Responsible for monitoring in an objective fashion all customer contact points. (Web, voice, e-mail, white mail)
  • Responsible for reporting all behavior that does not conform to the quality standards set by the company and the account management.
  • Designs and implements reports to establish patterns and trends of quality issues as they may arise.
  • Provides quantifiable data to all quality judgments that are made.
  • Works with operations as an auditor as well as regulator of quality issues.
  • Works with Training and Operations to provide trend reports to address any issues that need refresher training.
  • Conducts calibration session with the client and with Operations.
  • Conducts product specific coaching sessions with the agents regarding trends and quality.
  • Responsible in releasing updates and training flashes to Operations and Training group.
  • Handles incoming calls and/ or escalated calls and meets telephone productivity standards.
  • Follows other tasks and/ or offline tasks assigned by his Training/ Quality Managers.

Process Improvement:

  • Offers suggestion for continuous improvement of processes and systems

General Safety and Security

  • Protects the organization's assets by upholding the principles of the Quality Information Security Management System (QISMS)
  • Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization's business functions
  • Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act and URAC

COMPETENCY REQUIREMENTS:

With Basic Competency Level in the ff.:

Excellent interpersonal skills Ability to understand and interpret policy provisions. Product knowledge Typing Skills Problem Solving Skills

With Moderate Competency Level in the ff.:

US Healthcare Delivery System Philippine Healthcare Delivery System Clinical Skills US Healthcare 101 Customer Service orientation Computer literate Interpersonal Skills Sense of Urgency Passion for Excellence

OTHER REQUIREMENTS:

Reports to:

Quality Assurance Supervisor/Lead

Education and/or Experience:

  • Preferably an Active Philippines Certified Registered Nurse (RN) with minimum 2 years post education clinical experience.
  • Or Graduate of any 4-year course, preferably of a life-science course with 1 – 2 years of relevant work experience gained in a customer service-oriented environment

Certificates, Licenses, Registrations:

  • Active Philippine Certified Registered Nurse (RN) and country mandated license requirements.
  • For USRN Lines of Businesses: Unrestricted US Certified Registered Nurse (USRN) license, state license requirements, CEUs and state mandate requirements.

Language Skills:

English, additional language a plus. Strong communication and interpersonal skills.

Computer Skills:

MS Office.

Work environment:

  • The work environment is professional, office.
  • Business casual attire.

Physical demands:

  • May require weekend, evening or shifting work schedule.

Location:

BangaloreIndia

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