Quality Analyst (performance improvement coordinator)KMC MAG Solutions Inc

QUALITY ANALYST (PERFORMANCE IMPROVEMENT COORDINATOR)
 
Functional Overview
 
Position Summary:
 
Supports department quality improvement initiatives by conducting audits of customer service and prior authorization transactions, providing call coaching and training to staff, and participating in department quality improvement studies. This position is part of a three level career path with progression opportunities described in the Core Service Career Path/Succession Planning 
Guidelines.
 
Duties and Responsibilities:
Completes quality audits of customer service and prior authorization transactions to ensure timely and accurate information is provided to callers. Evaluation of calls includes, but is not limited to, review of overall call handling, courtesy, accuracy, documentation, system knowledge, correct use of policies and procedures, timely answers, and other criteria identified in the quality assurance guidelines. 
Provides monitoring feedback to staff and department leadership team.
Submit reports of audit results to the department leadership team.
Provide overall analysis of quality scores and identify trends for training purposes. 
Supports department training and skill development initiatives through call coaching, mentoring, and training staff as assigned.
Recommend training program improvements or any additional customer service training needs.
Identify training needs and develop training reminders for staff.
Develops, maintains, and administers the Level II and Over-dollar examinations.
Provides training and feedback on examination results. 
Participates in the development of department Required Training Lessons (RTL) to improve customer satisfaction based on client feedback and training issues identified through call monitoring.
Identifies areas for additional training based upon RTL results.
Recommends workflow process improvements or enhancements to department leadership team. 
Contribute to the development of MedAccess enhancements through recommendations.
Audits and provides analysis for the Customer Service Survey line.
Attends and participates in monthly staff meetings.
Prepares and provides training materials as needed.
Provides input to ensure audit results and service or training issues are communicated to staff members. 
Organizes and conducts monthly Call Monitoring Cohesiveness meetings.
Provides feedback to department leadership team.
Compiles current company and department information, training issues and other articles for publication of the quarterly department newsletter. 
Supports the department by answering calls during periods of high volume, assisting on the internal Help Desk, and assisting with other related tasks.
Minimum Competencies:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 
The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Competencies:
To perform the job successfully, an individual should demonstrate the following competencies:
Customer and Quality Focus - Actively demonstrates a personal concern for understanding client needs, ensuring the quality of products and services, maintains a high level of customer satisfaction, and contributes to continuous improvement of products and processes.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries 
new things.
Communication - Expresses self clearly and effectively in face-to-face interactions, presentations and written documents, and employs active listening skills to ensure productive interactions.
Teamwork - Functions as a valuable team member by engaging in collaborative decision making and problem solving, constantly contributes positively as a team member, shares credit when appropriate and encourages teammates to use their knowledge and skills.
Organizational Support - Follows policies and procedures; Completes tasks correctly and on time; Supports organization's goals and values.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Adaptability - Adjusts quickly to evolving situations by integrating new information, remaining flexible, recognizing and implementing necessary changes and taking advantage of opportunities presented by new developments.
Reliability - Maintains good record of attendance and punctuality, conscientiously follows through on actions without excessive need for supervision, fulfills commitments.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Initiative - Proactively gathers and analyzes information, assesses situations and identifies challenges and opportunities, sees what needs to be done and takes appropriate action.
Minimum Qualifications:
Associate's degree (A.A.) or equivalent from a two-year College or technical school; or six months to one-year related experience and/or training; or equivalent combination of education and experience; two to five years call center customer service experience; PBM, Health Plan, or Healthcare background preferred.
Current and unrestricted licensure in a state of the United States or national certification as a pharmacy technician is preferred.
Other Skills and Abilities:
Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and 
commitment. Demonstrated ability to meet or exceed the competencies as listed.
Language Skills:
Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Reasoning Ability:
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations
Mathematical Skills:
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to interpret bar graphs.