Campus Pride Jobs

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Under the direction of the Quality Assurance Supervisor, the Quality Assurance Specialist listens to and scores calls based on Point32Health policies, procedures, workflows, and the quality program documentation. The Quality Assurance Specialist will be responsible to attend several meetings to ensure consistent scoring between Quality Assurance and the call center and/or third-party evaluators, identify trends, and suggest process improvements. The Quality Assurance Specialist will be responsible to communicate call findings to the Call Quality Supervisor, Operations Quality Assurance Manager, and call center/third party leadership. The Quality Assurance Specialist will also be responsible for supporting applications associated with the call monitoring process. Through call monitoring and analysis of relevant quality data, the Quality Assurance Specialist assesses staff performance and recommends appropriate intervention.

Key Responsibilities/Duties -- what you will be doing

• Listen to and scores Provider Service calls and compares them to evaluations completed by third party evaluators. Identify any discrepancies and provides feedback for improvement to the appropriate supervisor/manager. Will also communicate any trending concerns to the appropriate supervisor/manager. Create and maintain relationships with third party vendor.
• Listen to and scores Member Services calls and identify educational needs for new and existing Point32Health employees through call monitoring and recommend appropriate training intervention. Monitor and assess staff progress and communicate concerns and recommendations to appropriate supervisor/manager. Create and maintain relationships with supervisors to communicate on their staff's performance. Work with Training Enablement to identify trends and training opportunities.
• Attend several meetings including but not limited to staff meetings, calibration sessions and monthly quality review meetings.
• Present a Quality Assurance overview during new hire training. Facilitate calibration sessions with the new hires to demonstrate how scoring is based on the QA Call Quality Guidelines.
• Maintain a high degree of subject area expertise by attending training, Call Center All Staff meetings, and reading updates in SupportPoint.
• Update and track quality program based on quality scores.

• Carry out special projects and serve on committees as requested by the OQA Supervisor.

   

Qualifications -- what you need to perform the job

EDUCATION, CERTIFICATION AND LICENSURE:

• Associates Degree or equivalent relevant work experience is required
• Bachelor's Degree is preferred.

• Knowledge of Microsoft Word, Excel, PowerPoint and the ability to learn other office systems desired.

   

EXPERIENCE (minimum years required):

A minimum of one year experience as a Customer Service representative or as a Quality Assurance specialist is required.

Two or more years of experience are preferred.

Must have