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Quality Review Specialist
3 months ago
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply
Our people make all the difference in our success.
Quality Control Specialist (Military One Source)
Role Summary:
The Quality Control Specialist's (QCS) primary responsibility is to uphold the highest standards of quality and compliance within the Military OneSource program. The QCS will conduct thorough quality audits on program performance, SLAs, and session documentation to ensure accuracy and compliance with regulations and standards. This role is responsible for tracking the on-time delivery of quality requirements through close collaboration with teams to address any discrepancies or areas for improvement, ultimately contributing to the overall success and efficiency of the program. Attention to detail, analytical skills, and a commitment to excellence are essential for excelling in this position.
Major Responsibilities:
The QC Specialist shall be aligned to the evaluation of quality audits. They will review case management documentation of patient interactions with service provider using quality scorecard in the MyQuality platform, measuring service delivery against URAC and identified service standards, production targets and deliver all work on-time and within designated cadence. The QCS is responsible for providing scorecard performance results, identifying trends and action plans and providing this information reliable consultation to aligned leaders. The QC Specialist shall adhere to auditing standards, participate in team meetings, training requirements and calibration sessions. The Journeyman QC Specialist will provide support/consultation to Junior level Quality Control Specialists. The Journeyman role will provide input into the evolution of the Quality Control Specialist role and the overall Quality Management Program. The Journeyman QC Specialist will cross-train and provide back up to additional teams as needed
Technical Skills & Education:
It is required that the QC Specialist has the following qualifications: Must be a U.S. citizen and must speak fluent English. A minimum of a Bachelors degree from an accredited undergraduate program. A minimum of 4 years of experience in call center operations or quality auditing. Must possess strong customer service skills, ability coordinate and focus on deliverables, communicate clearly and in a supportive manner, problem solve and effectively identify and use available resources.
**ALL quality roles must have experience in quality, audit, SLA or something related. Higher level: clinical/healthcare/mental health experience nice to have.
***ALL MUST have experience with quality in a large program (COA/URAC accredited, or similar). Must pass government-issued background check (tier 2 suitability).
In addition, the following requirements should be met:
- Ability to manage multiple projects simultaneously
- Good organizational Skills
- Strong interpersonal and relationship building skills
- Excellent oral and written communication skills
- Strong technical and computer skills
- Ability to teach and mentor
- Innovative and creative thinking
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
