Senior Quality Assurance Advocate

Coupe Health•Eagan, MN

4d•$61,200 - $97,800•Remote

About The Position

About Coupe Health Healthcare today is complicated and confusing. Coupe Health changes that. Coupe delivers a different healthcare experience – one that is streamlined and simplified, saving our members time and money. At Coupe, we are passionate about transforming healthcare. Come join our team. The Impact You Will Have This role is responsible for conducting Coupe Customer Service quality reviews in order to build a consistent customer experience, to advocate for our members, and to provide associates and leadership with feedback in support of improved performance. This role also provides objective insights through the monitoring of compliance with documented rules and requirements. The Senior Quality Assurance Advocate utilizes the data gathered through the Health Valet Quality Review process to provide recommendations to our business partners in support of improved processes, improved training experience, and enhanced associate experiences through mentoring and individualized feedback.

Requirements

1+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
Minimum of 18 months in the Quality Assurance Advocate role with experience in multiple lines of business and/ or in two or more of the following areas: Customer Service, Claims, Membership, International Standard on Quality Control ( ISC), Appeals & Grievance, Payment Integrity
Self-Starter with high initiative
Proven ability to work independently
Excellent organizational skills with strong attention to detail
Demonstrated track record of achievement with ability to identify opportunities and deliver on customer expectations.
Strong collaboration, problem solving and consensus building skills
Demonstrated effective interpersonal and conflict resolution skills
Excellent verbal and written communication skills
Proven ability to interpret and analyze data, draw conclusions, and provide recommendations for process improvement
High school diploma (or equivalency) and legal authorization to work in the U.S.

Nice To Haves

Bachelor’s degree
Previous experience providing feedback, coaching, and mentoring
Experience using Salesforce or other CRM tools
Strong Excel skills, including data analysis and reporting
Familiarity with NCQA standards

Responsibilities

Perform and document quality review checks for Operations business partners that support best practices and improve overall customer experience
Analyze quality review results to provide associate feedback and to identify trends and opportunities for improvement in collaboration with Leadership and Training
Represent the Quality team as a subject matter expert to provide data and recommendations in meetings with our business partners
Identify and streamline processes, workflows, and standards to enhance service delivery and the customer experience
Develop and conduct targeted group and/or individual coaching sessions that address quality deficiencies and/or improvement opportunities
Analyze data to provide personalized mentoring and feedback to associates which may include side-by-side reviews of audits, and a detailed process instruction
Identify gaps in associate knowledge, skills and understanding in order to make improvement suggestions to both the associate and their leadership
Host job shadowing sessions
Assist in the training, mentoring, and coaching of a new or existing Quality team members
Support new hire associates with hands-on interactive training and feedback
Adapt to evolving healthcare guidelines and processes to help associates provide accurate and complete information to members who are on their health journey
Act as a compliance partner to mitigate risk and ensure HIPPA and NCQA accreditation standards are met