Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
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Quality Analyst
🔍 New York, New York
Summary of Position
- Responsible for assessing the quality of performance of employees who handle calls from our existing and potential members, providers, patients and customers.
- Provide full evaluation and feedback on customer service skills and call handling to employees throughout the Call Centers across the Enterprise.
- Ensure ongoing compliance with quality and industry regulatory requirements as well as identifying and tracking performance trends and making recommendations to employees for improvement.
Job Responsibilities
- Audit staff and delegated entities to identify and investigate trends in audit results, identify root causes, report accuracy and compliance, analyze impacts, and generate recommendations to address.
- Conduct analysis in a professional and confidential manner with a focus on the three critical quality components: technical accuracy, soft skills, and proper routing, resolution and documentation.
- Perform research and collaborate on projects as needed.
- Track issues in the quality monitoring systems or tools and analyze the results.
- Develop, continue to update, and deliver Quality Analysis training program for new team members.
- Deliver new hire auditing overview and orientation programs.
- Remain current with updates to industry standards regarding metrics relative to audit best practices, reporting trends and industry standard changes.
- Provide overviews in a team environment to educate the staff on audit results and trends; discuss team results on a regular basis.
- Perform other job-related duties as directed or required.
Qualifications
Bachelor’s Degree
- 2 – 3+ years’ relevant, professional work experience.
- 2 + years’ experience with Quality auditing.
- Additional experience/specialized training may be considered in lieu of educational requirements.
- Customer Service / Call Center experience.
- Excellent analytical and problem-solving skills.
- Thorough understanding of systems and policies and procedures.
- Proficient with MS Office (Word, Excel, Outlook, Power Point)
- Strong communication skills (verbal, written, presentation, interpersonal).
- Attention to detail; organizational and time management skills; analytical and problem-solving skills.
- Proven ability to successfully manage multiple tasks/projects with competing priorities and deadlines.
- Ability to adapt to changes in workflow, projects, tasks, environments, procedures, etc.
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.