Operations Quality Auditor

  • location: Tampa, FL
  • type: Contract
  • salary: $15.29 per hour
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job description

Operations Quality Auditor

job summary:
Are you looking for an opportunity where you feel valued as a team member and empowered to make decisions?

JOB SUMMARY

  • Perform compliance quality audits on all Inbound and Outbound teams including teams with Casework in Operations
  • Assist in the development of QA strategies on policies procedures and systems to accurately measure and report areas of improvement Manage turn-around times to ensure compliant with business requirements
  • Participate in any internal compliance or external CMS audit or state audit
  • Assist in the development of trending issues Recommend training improvement changes
  • Perform random Shopper Test Calls and Root Cause Analysis on Operational areas to ensure accuracy of departmental processes and identify when needed process improvement opportunities
ESSENTIAL FUNCTIONS Note: The following is not intended to be an exhaustive list of all duties required of this position

Key Duties and Responsibilities

  • To review telephone calls in accordance with Company's quality policy
  • Review casework (CTM Grievance) and call documentation for thoroughness and accuracy of information while meeting compliance turn-around-times in accordance with Company Policy and Procedure and any government (Federal or State) processes
  • Summarize and communicate to management audit results on a regular schedule
  • Assist with team training and attend calibration
  • Identify trends prioritize and recommend improvement in documentation and call handling
  • Assist in review of all CMS audits internal or external state audits Identify training opportunities individual and team coaching needs and reports findings to senior management
  • Develop and present ideas for performance and process improvement within the department
  • Acts as subject matter expert (SME)
  • Assist with other projects and duties as assigned
Additional Position Responsibilities Optional

MINIMUM QUALIFICATIONS Education State the minimum required for the job

Education Level Education Details Required/Preferred

  • A High School or GED Required
  • A Bachelor's Degree in a related field Preferred
Work Experience

State the minimum required for the job

Experience Level Experience Details Required/Preferred

  • 2+ years of experience in Customer Service Required
  • 5+ years of experience in directly related work Required
Licenses and Certifications

List professional licenses and certifications associated with this job

Licenses/Certifications Other Licenses/Certifications Required/Preferred

Skills State the minimum required for the job

Skill Sets Other Skills Proficiency

  • Ability to multi-task Intermediate
  • Ability to work in a fast paced environment with changing priorities Intermediate
  • Other Ability to remain calm under pressure Intermediate
  • Other Ability to sit for extended periods of time Intermediate
  • Other Demonstrated technical expertise in performing quality reviews along with analysis of results Intermediate
Technology List technical skills associated with the job

Technology Other Technology Proficiency Required/Preferred

  • Microsoft Outlook Intermediate Required
  • Microsoft Word Intermediate Required
  • Microsoft Excel Intermediate Required
  • Microsoft PowerPoint Intermediate Required
  • Other Knowledge of additional software programs as necessary Intermediate Required
Languages List all that apply Languages Other Languages Required/Preferred

 
location: Tampa, Florida
job type: Contract
work hours: 8 to 5
education: High School
experience: 5 Years
 
responsibilities:
JOB SUMMARY

  • Perform compliance quality audits on all Inbound and Outbound teams including teams with Casework in Operations
  • Assist in the development of QA strategies on policies procedures and systems to accurately measure and report areas of improvement Manage turn-around times to ensure compliant with business requirements
  • Participate in any internal compliance or external CMS audit or state audit
  • Assist in the development of trending issues Recommend training improvement changes
  • Perform random Shopper Test Calls and Root Cause Analysis on Operational areas to ensure accuracy of departmental processes and identify when needed process improvement opportunities
ESSENTIAL FUNCTIONS Note: The following is not intended to be an exhaustive list of all duties required of this position

Key Duties and Responsibilities

  • To review telephone calls in accordance with Company's quality policy
  • Review casework (CTM Grievance) and call documentation for thoroughness and accuracy of information while meeting compliance turn-around-times in accordance with Company Policy and Procedure and any government (Federal or State) processes
  • Summarize and communicate to management audit results on a regular schedule
  • Assist with team training and attend calibration
  • Identify trends prioritize and recommend improvement in documentation and call handling
  • Assist in review of all CMS audits internal or external state audits Identify training opportunities individual and team coaching needs and reports findings to senior management
  • Develop and present ideas for performance and process improvement within the department
  • Acts as subject matter expert (SME)
  • Assist with other projects and duties as assigned
Additional Position Responsibilities Optional

MINIMUM QUALIFICATIONS Education State the minimum required for the job

Education Level Education Details Required/Preferred

  • A High School or GED Required
  • A Bachelor's Degree in a related field Preferred
 
qualifications:
Work Experience

State the minimum required for the job

Experience Level Experience Details Required/Preferred

  • 2+ years of experience in Customer Service Required
  • 5+ years of experience in directly related work Required
Licenses and Certifications

List professional licenses and certifications associated with this job

Licenses/Certifications Other Licenses/Certifications Required/Preferred

Skills State the minimum required for the job

Skill Sets Other Skills Proficiency

  • Ability to multi-task Intermediate
  • Ability to work in a fast paced environment with changing priorities Intermediate
  • Other Ability to remain calm under pressure Intermediate
  • Other Ability to sit for extended periods of time Intermediate
  • Other Demonstrated technical expertise in performing quality reviews along with analysis of results Intermediate
Technology List technical skills associated with the job

Technology Other Technology Proficiency Required/Preferred

  • Microsoft Outlook Intermediate Required
  • Microsoft Word Intermediate Required
  • Microsoft Excel Intermediate Required
  • Microsoft PowerPoint Intermediate Required
  • Other Knowledge of additional software programs as necessary Intermediate Required
Languages List all that apply Languages Other Languages Required/Preferred

 
skills: Other
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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