Healthcare - Quality Specialist

Quality Specialist

Are you interested in mental health? Our partner is building a new mental healthcare system that everyone can access. We are looking for a Quality Specialist who will work with patients to help them find an in-network mental health provider and will also work with the insurance payers as well as facilitate successful operations by directly leading a team of associates and helping to optimize the team's contribution to the partner's operations. This team's mission is to deliver on the partner's promise to providers, and in this role, you will ensure this mission through one-on-one interactions with our insurance payers and patients. By working with customers through email and phone you will guide them through any challenges, and resolve their operational and technical issues. You will consistently identify any trends and patterns in our providers' and patients' experience, and advocate for process and product changes to remove any friction and create a delightful experience. A successful candidate will be able to accurately and consistently score an interaction against a QA rubric, provide actionable recommendations based on trends observed, fully master the product and processes, keep up with changes and be on the lookout for ways to improve the quality program overall. The ideal candidate will be detail-oriented while able to see the big picture, a strong independent worker, who is able to confidently express areas of improvement backed by data.

What You'll Do :

• Utilizing a quality scoring tool to log insights, and provide product feedback to improve the tool
• Reviewing and scoring associate interactions according to an established rubric, evaluating for quality and compliance
• Providing meaningful feedback to associates or leadership based on an established rubric, program policies and guidelines, or designated product workflows
• Completing all assigned evaluations within the designated calendar day or calendar week
• Following evaluation process as documented by leadership and the partner
• Maintaining all performance standards as outlined by leadership or the partner for the Quality Specialist role
• Preparing or creating reports for Team Leads, Program Managers, and other key stakeholders regarding trends in associate performance and opportunities for process or training improvements.
• Participating in root cause analysis (RCA) of qualitative and quantitative data regarding individual and team-wide performance.
• Assisting in training and mentoring other QA Specialists as needed.
• Participating in regular meetings for calibration and coaching strategy, both within the team and for leadership
• Developing insights and recommendations from analysis of quality audits and delivering insights to leadership or key stakeholders within the designated timelines
• Remaining up to date on all necessary processes, products, and policies within the operation
• Participating in and facilitating proactive communication to leadership, the partner, or key stakeholders regarding trending behaviors, product feedback, or business impacts
• Collaborating with cross-functional team or partners within PartnerHero or the partner organization to innovate processes and procedures
• Assisting with tickets up to 100% of scheduled productive time during backlogs and as requested by leadership, the partner, or key stakeholders
• Maintaining all performance standards as outlines by leadership or the partner for the Customer Support Specialist role
• Adhering to all Compliance and Professionalism standards set by PartnerHero or the partner organization

What We Expect From You :

What You'll Get In Return :

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Crescendo is proud to be an equal-opportunity workplace. We value diversity, inclusion, equity, and belonging and these pillars are at the heart of how we work together. We are committed to providing equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, Veteran status, or any other applicable legally protected characteristics in the location in which the candidate is applying. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.

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