The Quality Assurance Specialist ensures that employee interactions with the patient meet established quality standards and compliance requirements. This role is responsible for monitoring, evaluating, and analyzing calls and non-calls documents to identify areas of improvement ensuring consistent and high-quality service. 

Essential Duties and Responsibilities:

• Responsible for reviewing and evaluating recorded or live call interactions to assess employee performance, accuracy, and adherence to scripts; quality rubrics, escalations, and compliance with company policies and procedures. Additionally, responsible for providing detailed verbal and/or written constructive feedback to employees and leadership through audit notes, highlighting strengths and identifying areas for improvement to ensure alignment with quality standards, performance goals, and expectations, driving continuous improvement across the team. The role also involves monitoring multiple areas of the business, new and ongoing projects, including calls for both internal and external partners, to ensure consistency in quality and service delivery. Furthermore, reviewing and auditing system documentation, such as emails, text/SMS, and chat communications, with a focus on accuracy and ensuring adherence to departmental procedures and company policies, is a key aspect of the role.
• Collaborate with Training and employee leadership to coach, train, and develop scheduling coordinators. Advocate for and implement process improvements to enhance operational efficiency and elevate customer satisfaction. Participate in regular calibration sessions with fellow Quality Assurance Specialists and Outreach management to maintain consistency in scoring and evaluation standards.
• Engage in Quality Assurance and TeamCare meetings to provide clarification and address inquiries related to scorecards and guidelines, ensuring consistency and understanding throughout the team. Act as a subject matter expert for employees, supervisors, training and management, offering insights and resources to enhance performance and adherence to standards.
• Other duties as assigned.

Required Skills and Abilities:

• Skilled in reviewing and assessing call recordings, documentation, and processes to ensure compliance with company policies, procedures, and quality standards. Experienced in utilizing quality rubrics and scorecards to evaluate employee performance effectively.
• Proficient in using quality management software and systems such as NICE, Vida, or proprietary QA platforms for call monitoring, score-carding, and reporting.
• Experienced in identifying quality issues, non-compliance, and risks, assessing their impact, and implementing preventive measures to mitigate potential risks and ensure continuous compliance with quality standards.
• Proficient in documenting audit findings with precision and objectivity, ensuring accuracy in reporting. Adept at producing comprehensive QA reports for management that highlight key trends, critical issues, and opportunities for improvement.
• Extensive knowledge of industry-specific regulations and quality standards, including HIPAA,  and ISO. Proven ability to ensure full regulatory compliance across processes and services, aligning with internal policies.
• Expert in leveraging performance data to identify trends, uncover gaps, and drive strategic improvements. Proven ability to deliver insightful reports for management and stakeholders to support data-driven decision-making.
• Expertise in utilizing call monitoring software to evaluate live and recorded interactions, ensuring compliance with scripts and accuracy of information. Skilled in assessing both soft skills, such as tone and empathy, and technical skills, including accuracy and regulatory compliance, to optimize customer interactions.
• Experienced in providing constructive, actionable feedback by identifying employee strengths and areas for improvement, and offering personalized training sessions to support their learning and development.
• Analyzing and spotting patterns in employee performance to create training that addresses skill gaps and enhances service delivery.
• Strong skills in quality process improvement, including the ability to recommend and implement enhancements to workflows, QA practices, or auditing techniques.
• Ability to track and meet Key Performance Indicators (KPIs) and Service Level Agreements (SLAs) related to quality, compliance, and performance.
• Familiarity with Continuous Quality Improvement methodologies to drive systemic enhancements in processes and quality measures over time.

Required Education and Experience:

• 3 years of quality auditing experience
• 2 years of call center experience
• Experience with call monitoring, coaching, and mentoring with the purpose of improving call quality
• High School Diploma

Preferred Education and Experience:

• Healthcare Industry experience
• Post-secondary education

Physical Requirements:

• The position involves prolonged periods of sitting at a desk and working on a computer.
• It is a fully remote role, with the potential for travel for activities such as on-site retreats occurring two to three times per year.