About

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Role Description

As an Accolade Care Advocate Quality Assurance (QA) Specialist, you will be a key member of the Quality Assurance Team for our Care Advocates. You will be responsible for:

• Monitoring and evaluating client call interactions and associated documentation
• Documenting performance strengths and weaknesses using QA tools
• Providing feedback to Stewards utilizing audit results
• Highlighting compliance, documentation and/or process issues
• Ensuring consistency in service expectations and process standards among Health Plan Health Assistants, Care Advocates, Claims & Benefits staff, Health Care support staff, and other non-clinical employee interactions
• Ensuring adherence to service expectations and process standards
• Providing ongoing feedback to key organizational partners on client satisfaction and client perception

Qualifications

• Bachelor's degree or High School Diploma/GED with 5+ years of relevant experience
• Experience from a customer care/call center environment
• Previous experience in a Quality Assurance role and/or proficiency using call recording/monitoring system are preferred
• General computer literacy
• Strong communication skills both in written and verbal
• Proven communications and interpersonal skills
• Solid business acumen, analytical, and inquisitive
• Self-starter with a “roll up your sleeves” mindset and desire to add value
• Comfortable operating with change and uncertainty
• Openness to learn new tools and systems
• Client focused
• Ability to set priorities and stay focused
• Internal applicants: Successful tenure at a level III required, preferably a Care Advocate role
• Demonstrated ability to achieve/exceed performance metrics, including QA scores, adherence, process knowledge, and system knowledge
• Demonstrated knowledge of specific regulatory compliance guidelines and company policies (i.e. HIPAA)

Requirements

• Monitor, evaluate, and score clients’ interactions (e.g. calls, mobile messages) according to Accolade’s defined internal standards
• Utilize quality dashboards and other automated tools to provide analysis and insights into performance opportunities
• Listen and research recorded calls to identify rationale for variances and inconsistencies in policy adoption among Care Advocate Center representatives
• Review all documentation in client record associated with calls
• Maintain a thorough understanding and ability to follow established process and procedures for Care Advocates and customers
• Provide feedback and evaluation to Quality leadership regarding trends in variances of established policies, procedures, engagement models
• Ensure call handling compliance with following up on member issues, conditions, contextual red flags and that the client is supported beyond their initial reason for calling
• Based on call calibration analysis, recommend process and policy improvements to reduce costs and inefficiencies
• Identify opportunities for development and work with Learning & Development to create customized learning opportunities
• Consistently meet departmental expectations regarding productivity and calibration
• Participate and complete all relevant training and education for Front Line Care Team employees to provide feedback and evaluations in compliance with

Benefits

• Comprehensive medical, dental, vision, life, and disability benefits, including access to Accolade Advocacy, Accolade Care, and Accolade EMO
• HDHP medical plan with generous employer contributions towards an HSA
• 401(k) Retirement Plan with matching employer contributions
• Accrued Vacation time
• Accrued Sick & Safe Time Off
• Generous Holiday Schedule + 5 floating holidays
• Paid parental leave
• Subsidized commuter benefits programs
• Virtual access to coaching, self-care activities, and video-based therapy and psychiatry through Headspace
• 1 Volunteer day per year