Quality Assurance Specialist
WFA Digital Insight
The shift towards remote work has amplified the need for quality assurance specialists who can ensure seamless operations and compliance. With the healthcare industry experiencing significant growth, professionals with expertise in regulatory requirements and process improvement are in high demand. SCAN, a nonprofit health organization, is at the forefront of this change, seeking a Quality Assurance Specialist to maintain high standards of service excellence. As the demand for skilled professionals in this space continues to rise, candidates with a strong background in healthcare and quality assurance will have a competitive edge. Before applying, candidates should be prepared to demonstrate their knowledge of regulatory compliance and their ability to drive process improvements.
Job Description
About the Role
The Quality Assurance Specialist role at SCAN is a pivotal position that ensures the organization's operations are compliant with regulatory and company standards. This role is responsible for monitoring staff and processes, identifying areas for improvement, and implementing corrective actions to maintain the highest level of service excellence. As a key member of the team, the Quality Assurance Specialist will work closely with various departments to develop and implement standards, workflows, and processes that meet or exceed regulatory requirements.The day-to-day responsibilities of this role will involve maintaining regulatory compliance, ensuring staff provide a level of service that meets or exceeds customer expectations, and identifying and remediating deficient practices or processes. The Quality Assurance Specialist will also provide feedback on staff performance, participate in coaching, and measure the quality, effectiveness, and efficiency of the customer experience.
SCAN is a nonprofit health organization that has been serving more than 500,000 people across several states, with a mission to improve care for older adults. The organization is committed to combining compassion with discipline, innovation with stewardship, and growth with integrity. As a Quality Assurance Specialist, you will be part of a team that is dedicated to making a positive impact on the lives of older adults.
What You Will Do
- Ensure compliance with regulatory and company/departmental standards by monitoring staff and processes
- Develop and implement standards, workflows, and processes that are compliant with regulatory requirements and support the delivery of service excellence
- Maintain regulatory compliance by remaining knowledgeable of regulations and contractual requirements related to customer service operations
- Ensure that staff consistently provide a level of service that meets or exceeds customer expectations while being respectful, kind, and knowledgeable about SCAN benefits and services
- Identify and remediate deficient practices or processes by monitoring processes and staff interactions with customers
- Provide feedback on staff performance and participate in coaching of the staff
- Measure 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 assisting in the development and presentation of training
- Maintain awareness of membership and service issues by generating reports, analyzing data to identify trends, and making recommendations for improvement
What We Are Looking For
- Bachelor’s degree preferred
- 5+ years of experience, preferably within the healthcare industry
- Demonstrated efficiency and effectiveness in an environment with a high call volume
- 1+ years of prior experience with Medicare benefits, including Medicare Advantage Plans
- Experience in the healthcare, insurance, or pharmacy industry is highly desirable
- Excellent communication skills, both oral and written
- Strong interpersonal skills, including excellent verbal communication skills
- Ability to work in a remote environment and collaborate with teams virtually
Nice to Have
- Experience with quality assurance and process improvement
- Knowledge of regulatory requirements related to customer service operations
- Experience with data analysis and reporting
- Certification in a related field, such as quality assurance or healthcare management
Benefits and Perks
- Remote work arrangement
- 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
- Opportunity to become part of a mission-driven organization making a positive impact on the lives of older adults
How to Stand Out
- Tip: Highlight your experience with quality assurance and process improvement, and be prepared to provide specific examples of how you have implemented changes to improve customer service.
- Tip: Familiarize yourself with regulatory requirements related to customer service operations, and be prepared to discuss how you stay up-to-date with changing regulations.
- Tip: Showcase your analytical skills by providing examples of how you have analyzed data to identify trends and made recommendations for improvement.
- Tip: Emphasize your ability to work effectively in a remote environment and collaborate with teams virtually.
- Tip: Prepare to discuss your experience with Medicare benefits, including Medicare Advantage Plans, and how you have applied this knowledge in previous roles.
- Tip: Be prepared to provide examples of how you have provided feedback on staff performance and participated in coaching, and how you have measured the quality, effectiveness, and efficiency of the customer experience.
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