Operations Quality Assurance Analyst - Remote

$55,000 - $65,000/Yr

Paradigm - Tampa, FL

Full-time

Remote - Tampa, FL

Professional, Scientific, and Technical Services

About the position

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm's business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs. We are seeking a full-time, remote Operations Quality Assurance Analyst. The Quality Assurance Analyst is responsible for ensuring quality standards are compliant with customer requirements and consistent with company standards through quality audit processes and regular reporting. This role will aid in the design, development, and reporting of quality audit results and other quality metrics to management and compile weekly and monthly quality reporting to senior management. The candidate must be detail-oriented with a strong background in call center operations, quality management, and healthcare and/or workers' compensation.

Responsibilities

• Work collaboratively with all team members.
• Engage in regular audits of Contact Center agents and billers within the Network Services & Operations group.
• Assist in establishing quality audit and scoring process to meet optimum operational standards.
• Aid in developing reports at the individual level and at the aggregate level for management and senior management intake.
• Prepare and deliver regular audit results to operations managers.
• Prepare and deliver regular quality reporting metrics to Sr. Director of Operations & Network Services or other senior management as required.
• Identify trends in quality scoring over time that may help drive training needs and/or process changes.
• Work with managers to ensure consistency in scoring methodology across departments.
• Meet with operations management on a regular basis to review quality reporting, coaching needs, and process changes as a result of quality audit scoring.
• Ensure operations initiates corrective action plans and follows through when individual and/or team quality goals are not met.
• Act as quality subject matter expert.
• Provide and elevate any customer feedback to appropriate parties.
• Other duties as assigned.

Requirements

• Minimum of 3 years in a quality assurance or similar quality role
• Deep experience in call center metrics
• Excellent computer skills with knowledge of MS Office applications (Outlook, Word, Excel)
• Strong MS Excel skills (e.g. pivot tables, charts, formulas, and external data sources)
• Strong interpersonal communication skills, both verbal and written
• Decision-making and critical-thinking skills
• Problem-solving and conflict resolution
• Strong attention to detail, organizational skills, time management as well as ability to multitask and prioritize
• Exercise judgment and maintain confidentiality
• Bachelor's degree or equivalent work experience
• Ability to work independently
• Ability to travel as needed
• Ability to manage unexpected events and/or change

Nice-to-haves

• Experience in healthcare and/or workers' compensation
• Familiarity with quality management tools and techniques (e.g. root cause analysis, five whys, PDCA, pareto principle/charts)
• Certification in quality management (e.g. Six Sigma, Lean, ASQ) is a plus
• SQL querying skills