- Quality Assurance:
- Develop and implement quality assurance programs and processes to monitor inbound and outbound call interactions
- Conduct regular evaluations and audits of calls to assess adherence to scripts, compliance with regulations, and overall quality of service
- Provide constructive feedback and coaching to inbound and outbound specialists based on quality assessment findings
- Identify trends, patterns, and areas for improvement in call quality and performance and develop action plans to address them
- Collaborate with management and stakeholders to establish and maintain quality standards and best practices for member services
- Training and Development:
- Deliver comprehensive training programs for inbound and outbound specialists, including new hire orientation and ongoing training sessions
- Update training materials, manuals, and resources to support specialists' learning and development needs
- Conduct regular training sessions to enhance product knowledge, communication skills, customer service techniques, and compliance requirements
- Assess training needs and performance gaps and develop customized training plans to address them
- Provide one-on-one coaching and mentoring to specialists to support their professional growth and development
- Supervision and Leadership:
- Provide guidance, support, and direction to a team of inbound and outbound specialists
- Lead by example and foster a positive and collaborative work environment focused on excellence and continuous improvement
- Handle escalated member inquiries and complaints with professionalism and empathy, ensuring timely resolution and customer satisfaction
- Bachelor's degree in a related field or equivalent work experience
- A minimum of 3 years of experience in a leadership or supervisory role, preferably in a healthcare or customer service environment, is required
- In-depth knowledge of Medicare, Medicare Advantage, and Medicare Dual Special Needs Plans
- Proven experience in quality assurance, call monitoring, and performance evaluation.
- Strong understanding of healthcare systems, regulations, and compliance requirements
- Excellent communication, coaching, and mentoring skills
- Ability to effectively manage and prioritize multiple tasks and deadlines
- Proficiency in Microsoft Office, electronic medical records l, and other relevant software applications
- Maintain department SLAs and standards of service
- Proficiency with the Athena EHR platform
- Working knowledge of ZenDesk and RingCentral
- Proficiency with Google Docs, Sheets, Slides
- Experience working in a remote environment and with virtual care offerings
- Strong familiarity with referrals and prior authorizations
- Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
- Compassion and empathy
- Curiosity and an eagerness to listen
- Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
- Strong focus on the sustainability of our business and scalability of our services to maximize our reach and impact
- Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
- Taking our mission and business seriously, but not taking ourselves too seriously- having fun as we build
- Competitive salary and equity grant
- Unlimited PTO
- Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
- Company-sponsored 401k plan
- Hybrid working arrangement in a Homeward Hub: San Francisco, Chicago, Minneapolis, or Austin
Member Services Quality Assurance Lead/Supervisor - Chicago, United States - Homeward
Description
Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don't have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.
Our vision is care that enables everyone to achieve their best health. So, we're rearchitecting the way it's delivered - leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.
Most importantly, we're aligning everyone's incentives (ours, partner health plans', and members') towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member's healthcare and outcomes.
Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.
The Opportunity
Join us in tackling healthcare for rural America We're seeking a Member Services Quality Assurance Lead/Supervisor who is passionate about having a positive societal impact and using technology for good - solving issues of health inequity for communities that have been perennially underserved.
As a member of our centralized Operations team, you will work closely with our in-market teams and cross-functionally with other centralized teams to support prospective and current members in meeting a variety of needs. You will play a critical role in ensuring the quality and effectiveness of both inbound and outbound call operations, as well as providing comprehensive training and support to inbound and outbound call specialists.
What You'll Do:
At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.
Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.