Job Description
Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise.
Primary duties may include, but are not limited to:
- Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
- Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
- Tracks and trends audit results, providing feedback to management.
- Conduct calibration sessions to evaluate and ensure that all teams are aligned with the set QA guidelines.
- Identifies and reports on systemic issues which create ongoing quality concerns.
- Conducts root cause analysis to determine the underlying causes of noted quality opportunities using the RCA tools.
- Recommend, implement, and monitor preventive and corrective actions to ensure that quality standards are achieved.
- Generates monthly r...