Quality Assurance Specialist

SCAN Health Insurance•Yountville, CA

1d•Remote

About The Position

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 277,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter. Job Description: Quality Specialist Fully Remote The job Ensures compliance with regulatory and company/departmental standards by monitoring staff and processes, and implementing corrective action, as required. Improves service quality and efficiencies by developing and implementing standards, workflows and processes that are compliant with regulatory requirements and supports the delivery of service excellence. You will Maintain regulatory compliance by remaining knowledgeable of regulations and contractual requirements related to customer service operations, developing and implementing processes and policies/procedures that meet or exceed requirements. Ensure the SCAN commitment of service excellence to our customers by ensuring that staff consistently provide a level of service that meets or exceeds the customer’s expectation while being respectful, kind and knowledgeable about SCAN benefits and services. Identify and remediate deficient practices/processes by monitoring processes and staff interactions with customers, providing feedback, identifying trends and overseeing and measuring corrective actions. Provide management with feedback on staff performance and participate in coaching of the staff. Improve service quality by measuring the quality, effectiveness and efficiency of the customer experience and provide recommendations for improvement to management. Support the Member Services Trainer by providing feedback on training needs and assist in the development and presentation of training, as required. Maintain awareness of membership and service issues by generating reports, analyzing data to identify trends, and making recommendations for improvement. Contribute to team effort by accomplishing related results, as needed. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Requirements

Bachelor’s degree
A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.
5+ years’ preferably within healthcare industry.
Demonstrated efficiency/effectiveness in an environment with a high call volume
Excellent communication skills, both oral and written.
Strong interpersonal skills, including excellent verbal communication skills.

Nice To Haves

1+ years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred
Experience in the healthcare, insurance or pharmacy industry highly desirable.

Responsibilities

Ensures compliance with regulatory and company/departmental standards by monitoring staff and processes, and implementing corrective action, as required.
Improves service quality and efficiencies by developing and implementing standards, workflows and processes that are compliant with regulatory requirements and supports the delivery of service excellence.
Maintain regulatory compliance by remaining knowledgeable of regulations and contractual requirements related to customer service operations, developing and implementing processes and policies/procedures that meet or exceed requirements.
Ensure the SCAN commitment of service excellence to our customers by ensuring that staff consistently provide a level of service that meets or exceeds the customer’s expectation while being respectful, kind and knowledgeable about SCAN benefits and services.
Identify and remediate deficient practices/processes by monitoring processes and staff interactions with customers, providing feedback, identifying trends and overseeing and measuring corrective actions.
Provide management with feedback on staff performance and participate in coaching of the staff.
Improve service quality by measuring the quality, effectiveness and efficiency of the customer experience and provide recommendations for improvement to management.
Support the Member Services Trainer by providing feedback on training needs and assist in the development and presentation of training, as required.
Maintain awareness of membership and service issues by generating reports, analyzing data to identify trends, and making recommendations for improvement.
Contribute to team effort by accomplishing related results, as needed.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base Pay Range: $45,300-$72,500
Work Mode: Remote
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)- 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
Excellent 401(k) Retirement Saving Plan with employer match
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!
We're always looking for talented people to join our team!
Qualified applicants are encouraged to apply now!
At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.
Become part of a mission-driven team that makes a difference in the lives of seniors every day. SCAN has a long history of finding and investing in ways to meet seniors' needs. This focus is what attracts employees to SCAN. For each and every one of us, the SCAN mission is personal. Keeping Seniors Healthy and Independent is both our mission and our passion. That same commitment carries over to our employees. We provide the training, tools and support necessary to do your work. We reward effort and celebrate success. SCAN both develops and attracts people who are leading experts in their respective fields. If the SCAN mission is one you believe in too, we invite you to explore the career opportunities at SCAN.
Why consider a career at SCAN?
A competitive compensation and benefits program
Generous paid-time-off (PTO)
Eleven paid holidays per year
Excellent Retirement Savings program
A work-life balance
An opportunity to become part of a team that makes a difference to our members and our community every day!