Contact Center Quality Assurance Specialist

Summary:

The Contact Center Quality Assurance Specialist will perform quality audits and reviews of all data submitted by the IDT teams and PACE Service Coordinators in Care Compass. The role will also perform a variety of duties audits, inspections, and analysis of entries, and be responsible to make modifications, confirm, and/or update patient service support documentation. This will include frequent communication with participants and collaboration with various teams to effectively collect and process participant data.

RESPONSIBILITIES:

–      Complete Quality validation calls to participants, providers, and home care agencies to confirm that all services requested were received. Capture and modify any data missing by the PACE staff who submitted the original request, and communicate to all parties key updates to ensure that deliverables are achieved for the participant.

–      Completion of assessment and coordination notes into Care Compass EMR database related to participant home care services received, supplies delivered, nursing duty sheets, and other data management as necessary.

–      Assist the Pace Services Coordinator Supervisors with a variety of tasks, including but not limited to, providing training to staff, managing, and handling escalated calls as needed.

–      Manage and prepare confidential information, such as patient services and data summaries, quality assurance reports, root cause analysis, the financial impact of errors, etc. and use any/all sources of information (ie. Staff documentation errors, missing information in Care Compass, validation calls, grievances, etc.).

–      Provides analysis reports of data information to management and prepares recommendations for review and/or changes to ensure higher quality standards of deliverables are met.

–      Coordinate and execute, with staff managers, training, and continuous workflow improvements with Pace Service Coordination staff. At times, will be responsible to coach / mentoring staff who demonstrate a significant number of documentation or assessment management errors.

–      Inspects participant’s requests submitted by PACE Service Coordinators and site-associated Care Delivery department to ensure deliverables are received, customer satisfaction, and data information is entered correctly and timely.

–      Post-inspection: conduct an evaluation and assessment of patterns, frequency, and summary of errors and/or gaps in goods, services, equipment, etc. Determine if errors are outliers or systemic issues and conduct root cause analysis.

–      Completes assigned monthly welcome calls for all new enrollments of the month, and validates that the participant received the correct information from the PACE staff.

–      Responsible for data entry and updating daily service-related information required for the service coordination team care planning for consistent and reliable delivery of all goods and services to participants.

–      Responsible for updating all Care Compass demographic updates including phone number, address, and interdisciplinary staff assignments.

–      Manages escalated issues, disputes, and replacement requests as assigned on the worklist.

–      Provides general administrative oversight support as needed.

–      Maintains departmental quality and productivity goals.

–      Adheres to all applicable compliance requirements and the Code of Conduct

 Requirements:

• Associates Degree preferred or equivalent relevant customer service, quality, and auditing experience preferred.
• Must be able to type at least 45 WPM.
• One – two (1-2) years’ experience in customer service, quality, and/or auditing experience.
• Excellent written and verbal communication skills.
• Ability to thrive in a fast-paced environment and meet assigned deadlines.
• Excellent organizational skills, accuracy, and attention to detail.
•  Ability to operate both independently and collaboratively as required.
• Proficiency in Microsoft Office Suite, including Word, Excel, and Outlook.