TOP Quality Auditor

International SOS-posted about 1 year ago
Full-time • Entry Level
San Antonio, TX
Ambulatory Health Care Services
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The Quality Auditor plays a crucial role in supporting the Quality Management System (QMS) by conducting monthly quality audits and generating analysis reports aimed at enhancing service delivery to TRICARE beneficiaries. This entry-level position involves monitoring customer experience feedback, managing the TOP Global Quality Inbox, and participating in quality improvement initiatives. The role serves as a foundational step for a career in quality management, providing coaching and development opportunities.

  • Perform daily quality process checks and audits of TRICARE service delivery, including monitoring inbound and outbound telephone calls.
  • Record findings from process audits, monitor trends, and identify root causes and opportunities for improvement.
  • Collaborate with the quality team to develop data-driven action plans for improvement.
  • Provide feedback to managers regarding areas for improvement and recommend coaching opportunities for team members.
  • Prepare monthly quality reports according to TRICARE Contract Data Requirements List and internal reporting guidelines.
  • Monitor the Quality Assurance Inbox, escalate issues, and log customer feedback in the customer feedback system.
  • Participate in monthly call calibration sessions and Training Needs Analysis Meetings.
  • Assist in developing Standard Operating Procedures (SOPs) in collaboration with Operational and Medical departments.
  • Perform case quality management reviews.
  • Some experience working in a quality role, preferably in healthcare, claims, insurance, or contact center environment.
  • Proficiency in Microsoft Office applications, specifically MS Word and MS Excel.
  • Knowledge or familiarity with the TRICARE Overseas Program is highly desirable.
  • Attention to detail and effective problem-solving skills.
  • Ability to communicate clearly and concisely, both verbally and in writing.
  • Ability to work collaboratively across teams and functions.
  • Knowledge of NPS methodology is advantageous.
  • Spanish language skills are desirable but not required.
  • Coaching and development opportunities for career growth.
  • Exposure to quality management practices and processes.
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