Quality Assurance Analyst

, CA, United States

Job Number 6806 Workplace Type : Fully Remote Remote-US , California By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

Alignment Healthcare is seeking an enthusiastic quality assurance analyst (QA) for their sales team who will be responsible for assessing the quality and performance of our call center associates who deal with our existing and potential customers. As a QA analyst, you will monitor inbound and outbound calls and email responses to assess associate’s demeanor, technical accuracy, customer service performance, and conformity to company compliance policies, carrier requirements, CMS regulations, and all other applicable federal and state laws. You will document and research client complaints, respond to the carrier and other inquiries, settle lead disputes, and promote our company’s goal of overall compliance. You will also assist in developing, creating, and implementing call center quality processes and procedures; as well as making recommendations for the development of training materials as needed to enhance the overall Alignment Health Plan member’s experience.

General Duties / Responsibilities

(May include but are not limited to):

Monitor and guide production personnel as required.

Audit sales/broker processes to ensure both internal and external regulations and standards are being adhered to and report findings to Sales Management

Provide insight to improve processes and practices to ensure sales quality is maintained while efficiency is optimized.

Participates in the design of call monitoring formats and quality standards.

Performs call monitoring and provides trend data to the call center management team.

Uses quality monitoring data management system to compile and track performance at team and individual levels.

Participates in customer and client listening programs to identify customer needs and expectations.

Provides actionable data to various internal support groups as needed.

Coordinates and facilitates call calibration sessions for call center staff.

Provides feedback to call center managers and the director.

Prepares and analyzes internal and external quality reports for management staff review.

Assist with new employee training and refresher trainings as needed.

Assist corporate trainer with employee enrichment training courses as needed

Perform call analysis for all CTMs/Grievances for multiple sales channels; provide results to Director of Compliance & Regulatory Affairs, compliance team

Perform other duties as assigned.

Supervisory Responsibilities

This position has no direct employee supervisory responsibilities.

Requirements

Minimum 4 years’ call center/sales experience; Medicare Health Plan knowledge preferred.

Bi-lingual preferred

Possess excellent verbal, written, and strong research skills

Attention to detail with strong knowledge and understanding of the CMS Marketing Guidelines and industry regulations

Outstanding customer service skills and dedication to providing exceptional customer care

Self-motivator and self-starter

Focused on quality and customer service

Exceptional listening and analytical skills

Effective time management skills

Efficiently deal with people at all levels inside and outside of the Company.

Maintain confidentiality and uphold standards for privacy and data integrity and security of the sales/broker staff telephone calls monitored and/or evaluated.

Creative ability and writing proficiency

Able to multitask and successfully operate in a fast-paced, team environment.

Adapt well to change and successfully set and adjust priorities as needed.

Proficient with Microsoft Office (Word, Excel, Outlook, etc.)

Experience using various systems including Salesforce, TalkDesk, and others.

Demonstrate ability to manage multiple tasks with competing priorities.

Pay Range: $42,900 - $64,400 annually.

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected] .

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