Quality Assurance Specialist I - Customer Experience

Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, or Nevada.

Job Summary

The Quality Assurance Specialist I is responsible for contributing to the development and maintenance of the overall Customer Service quality program and assessing quality performance. Using industry best practices and tools, the role monitors live and historical customer engagements and provides feedback to Customer Service Representatives (CSRs). This includes guidance on how to improve performance of compliance, process and service quality. The position also monitors and reviews customer feedback and incorporates the information into feedback for individual CSRs and overall customer service improvements.

Essential Responsibilities

• Recommend and maintain quality improvement changes to contribute to an exceptional quality program aimed at the use of best practices, transparency and consistency.
• Recommend enhancements or changes to tools and processes for tracking performance against customer service metrics; provide ongoing metrics reporting.
• Participate in implementing and ensuring continuous improvement of regulatory and process compliance, accuracy and efficiency.
• Partner closely with Customer Service leadership, CSRs, trainers, knowledge management staff and workforce management staff to integrate quality standards and recommend process improvement throughout the service delivery model.
• Partner closely with supervisors to improve individual CSR performance.
• Provide business requirements and guidance for quality related technology solutions.
• Contribute to the management and refinement of the quality assurance tool.
• Participate in facilitating quality knowledge transfer sessions to drive adoption of quality standards.
• Monitor live and historical customer engagements across all channels (voice, email, chat, etc.) to provide consistent and objective feedback to individual CSRs, teams and the department.
• Work with the Customer Experience Support and Logistics Manager to maintain the vendor relationship; participate in user groups to identify and implement new ideas for best practices.

Experience and/or Education

Required

• Experience in customer service support role(s)
• Minimum 2 years’ experience in the insurance or healthcare industry (e.g., claims, managed care, healthcare facilities, or other related industries)

Preferred

• Experience working with CareOregon Customer Experience or Operations processes and policies
• Excellent quality evaluation scores (in applicable roles)

Knowledge, Skills and Abilities Required

Knowledge

• Growing knowledge of contact center quality program best practices
• Proficient in Microsoft Word, Excel and PowerPoint
• Knowledge of exceptional customer service methods, techniques and results
• Knowledge of healthcare concepts, regulatory compliance concepts and related terminology

Skills and Abilities

• Growing analytical skills, including the ability to see trends and patterns in data

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Exceptional listening skills
• Ability to support and comply with organizational policies, procedures and guidelines
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to work effectively and positively with diverse individuals and teams
• Ability to participate constructively in departmental and organizational meetings and decisions
• Problem-solving skills, including the ability to recommend and participate in a course of action in response to data trends
• Ability to contribute to and occasionally manage well-defined projects with minimal guidance
• Ability to proactively contribute to positive and effective team dynamics
• Ability to effectively provide feedback, coaching and promote positive change in others
• Strong spoken and written communication skills
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day
• Motivated by natural curiosity to seek new ways to drive improvement
• Ability to work well under pressure in a complex and rapidly changing environment
• Good reading comprehension skills

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

#Li-Remote

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.