"Who We ArePoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.Job SummaryUnder the direction of the Quality Assurance Supervisor, the Quality Assurance Specialist listens to and scores calls based on Point32Health policies, procedures, workflows, and the quality program documentation. The Quality Assurance Specialist will be responsible to attend several meetings to ensure consistent scoring between Quality Assurance and the call center and/or third-party evaluators, identify trends, and suggest process improvements. The Quality Assurance Specialist will be responsible to communicate call findings to the Call Quality Supervisor, Operations Quality Assurance Manager, and call center/third party leadership. The Quality Assurance Specialist will also be responsible for supporting applications associated with the call monitoring process. Through call monitoring and analysis of relevant quality data, the Quality Assurance Specialist assesses staff performance and recommends appropriate intervention.Key Responsibilities/Duties - what you will be doingListen to and scores Provider Service calls and compares them to evaluations completed by third party evaluators. Identify any discrepancies and provides feedback for improvement to the appropriate supervisor/manager. Will also communicate any trending concerns to the appropriate supervisor/manager. Create and maintain relationships with third party vendor.Listen to and scores Member Services calls and identify educational needs for new and existing Point32Health employees through call monitoring and recommend appropriate training intervention. Monitor and assess staff progress and communicate concerns and recommendations to appropriate supervisor/manager. Create and maintain relationships with supervisors to communicate on their staff’s performance. Work with Training Enablement to identify trends and training opportunities.Attend several meetings including but not limited to staff meetings, calibration sessions and monthly quality review meetings. Present a Quality Assurance overview during new hire training. Facilitate calibration sessions with the new hires to demonstrate how scoring is based on the QA Call Quality Guidelines.Maintain a high degree of subject area expertise by attending training, Call Center All Staff meetings, and reading updates in SupportPoint.Update and track quality program based on quality scores.Carry out special projects and serve on committees as requested by the OQA Supervisor.Qualifications - what you need to perform the jobEDUCATION, CERTIFICATION AND LICENSURE: Associates Degree or equivalent relevant work experience is requiredBachelor’s Degree is preferred. Knowledge of Microsoft Word, Excel, PowerPoint and the ability to learn other office systems desired.EXPERIENCE (minimum years required):A minimum of one year experience as a Customer Service representative or as a Quality Assurance specialist is required.Two or more years of experience are preferred. Must have strong interpersonal, organization, analytical, and communication skills. Must be able to be objective and be able to multitask. SKILL REQUIREMENTS: Requires high degree of organization. Must be able to work within deadlines. Requires excellent interpersonal skills, a high level of diplomacy, and the ability to work with diverse populations from various departments. Requires excellent oral and written communication skills. Must possess initiative, balanced judgment, keen attention to detail, and the ability to plan, coordinate, and prioritize their own and others’ work to ensure maximum efficiency. Ability to learn and absorb complicated information quickly is extremely desirable. Must be able to work cooperatively as a team member. Must be willing to act as an instructor and mentor to all internal and external customers.WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):Must be able to work under normal office conditions and work from home as required.Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.May be required to work additional hours beyond standard work schedule.Operations Quality Assurance is a fast-paced office environment requiring that multiple demands be handled simultaneously. Must be able to exercise mature, appropriate judgment. Must be able to prioritize workload. Must effectively utilize various sources of communication to impart information to others. Must be able to move PC’s and furniture to set-up call monitoring station, if necessary. Must show scheduling flexibility to meet the needs of the department.The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.Compensation & Total Rewards OverviewAs part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:Medical, dental and vision coverageRetirement plansPaid time offEmployer-paid life and disability insurance with additional buy-up coverage optionsTuition programWell-being benefitsFull suite of benefits to support career development, individual & family health, and financial healthFor more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.PDN-9be1753b-651e-4c3b-a4c4-800c3e587d3c"