Job Information
TRIWEST HEALTHCARE ALLIANCE CORP Supervisor, TRICARE Quality Assurance in PHOENIX, Arizona
We offer remote work opportunities (AK, AR, AZ, CA, *CO, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI and WY only).
Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.
Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Job Summary
Supervises team of Quality Assurance Analysts staff involved in the following functions; building, scoring, completing and calibrating telephonic and electronic quality assurance assessments; conducting data entry quality compliance assessments; tracking, trending and analyzing quality trends; partnering with operational leaders identify process improvement opportunities and focused training agendas; performing ongoing Quality Assurance staff development; partnering with TriWests delegated vendors to communicate and standardize quality monitoring and performance management to ensure a consistent customer experience in accordance with established DHA expectations. This position ensures completion of weekly and monthly call and data entry assessments for TriWest and delegated vendor operations. The Supervisor will collaborate with TriWest leaders and delegated partner leaders to ensure consistent processes are in place and there is timely education of existing processes and program changes. The Supervisor may initiate, lead or participate in inter-departmental operational quality improvement projects and supervises TriWests Quality Assurance Analysts. The Supervisor will ensure that process changes are communicated and incorporated into quality assessments whether systematic or manual.
Education and Experience
Required:
Must be a U.S. Citizen Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation Bachelor's degree in a related field or equivalent work experience A minimum of 2 years of experience in a leadership or supervisory role in a healthcare or call center customer service environment Proven experience in quality assurance, call monitoring, and performance evaluation Strong understanding of healthcare systems, regulations, and compliance requirements Proficiency in Microsoft Office, call center quality tools, SharePoint, and other relevant software applications Preferred:
Certification in quality management (e.g. Lean Six Sigma) Health Care Operations Bachelor's degree in Business, or related field or equivalent experience Experience with using Verints software package to manage performance evaluations and agent quality scorecards TRICARE experience
Key Responsibilities
Successfully complete TriWest training in support of performance objectives expected from TriWest Call Center staff to ensure all DHA quality and compliance expectations are met. Utilizing the Verint system, develops and implements quality assurance programs and processes to monitor inbound and outbound call interactions to meet TriWests customer service and quality commitments to its Beneficiaries, Providers, and DHA Personnel. Conducts regular evaluations and audits of calls to assess adherence to scripts, compliance with regulations, and overall quality of service. Provides guidance, support, and direction to a team of Quality Assurance Specialists. Conducts calibrations per DHA regulations to meet expected quality targets; Provides constructive and actionable feedback and coaching to delegated vendor leaders, TriWest internal department leaders and stakeholders based on quality assessment findings. Identifies trends, patterns, and areas for improvement in call quality and performance and develops action lans to address them. Collaborates with the Quality Assurance Manager and TriWest Contact Center leaders to establish and maintain quality standards and best practices for TriWest Contac Center personnel.
Using data and best practices, identifies quality performance gaps and partners with TriWests Leadership and Training team to build training plans to address them. Holds meetings with TriWests delegated vendor leadership to make recommendations for resolving performance gaps. Assists the TriWest Quality Assurance Manager with remediation plans and expected follow up. Provides one-on-one coaching and mentoring to Quality Assurance Analysts to support their professional growth and development. Contributes to program governance, project reviews, cross-functional communications, training, and rewards programs. Serves as a change agent promoting development and integration of systems-thinking, customer focus, and commitment to continuous process improvement. Serves as subject matter expert on review committees and annual document reviews. Ensures quality check processes exist for quality assurance data before posted to official reports and scorecards. Partners cross-functionally to promote high-quality of Connect Listen Asses Solve Salute (CLASS) model and accuracy. .:
Delivers training and remedial coaching for direct reports to promote position specific performance improvement. Participates in special projects and meetings. Performs other duties as assigned. Regular and reliable attendance is required.
Competencies
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate. Coping / Flexibility: Resiliency in adapting to a variety of situations and individual