Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.


To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.

Manager, Quality - Customer Retention & Loyalty

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Manager & Professional
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EmblemHealth
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  • Lead the assessment of and drive quality performance to achieve targets on customer experience and operational performance.
  • Collaborate with counterparts in Service Delivery, and other operations areas e.g. Claims, Enrollment and Billing, Provider File Operations, to achieve end-to-end results across the EmblemHealth value stream. 
  • Responsible for driving continuous quality improvement.

Responsibilities:

  • Manage ongoing quality operations and engage Quality Specialists and Retention and Loyalty Navigators via daily or weekly huddles, transactional reviews, call listening sessions, corrective action drilldowns and formal Tollgate reviews.    
  • Develop a holistic quality assessment framework and supporting documentation such as scorecards to be utilized for assessing the Member Retention and Loyalty Navigators. 
  • Lead the definition of the regular and ad-hoc processes to leverage the findings from quality assessments including coaching and performance management.
  • Identify ongoing improvements to the quality framework including leveraging available and emerging technologies such as sentiment analysis and AI based live coaching.    
  • Communicate and collaborate with internal stakeholders (including but not limited to other Operational areas such as Claims, Marketing and Communications, Product Management, Network and Medical Management, Compliance and Quality Management) as needed to support overall EmblemHealth quality and customer experience objectives. 
  • Use Executive Briefing Tool when communicating milestones and status and selling ideas and proposals.     
  • Analyze trends and provide actional insights to management and executives on opportunities to improve quality.
  • Identify process efficiencies and opportunities for improvement. Work with all levels of management and staff to implement changes that enhance the customer experience and operational workflow.    
  • Support ad hoc initiatives as needed to align quality performance with corporate objectives.

Qualifications:

  • Bachelor’s degree; additional related experience/specialize training may be considered in lieu of educational requirements required
  • Quality Mgmt./Organization Excellence certification/equivalent; or achievement within 1 year of hire
  • 5 – 8+ years of relevant professional work experience required
  • Experience in Quality Management and Improvement, Change Management, and Customer Experience required
  • Energy, drive and passion for End-to-End excellence and customer experience improvement required
  • Excellent collaboration skills and the ability to influence management decisions required
  • Strong problem solving and analytical skills that be applied across all types of business problems required
  • Strong facilitation, oral and written communication and presentation skills required
  • Solid coaching and mentoring skills to continuously develop staff core competencies at vendors required
  • Demonstrated Customer Experience focus and 1 year of process improvement experience required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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