Quality Assurance Lead

Job Location: Horsham, PA About the position and responsibilities:Job Description:Summary: This position is responsible for strategic planning and direction of quality assurance/ Business Excellence team. With continuous quality improvement; primary emphasis for this position is placed on directing team members to consistently audit, record and monitor assigned business units productivity. Offer suggestions for continuous quality improvement as needed. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Responsible for ensuring and overseeing both company and client quality and efficiency standards are met.• Maintain records to evaluate performance and monitor progress of representatives across all company lines of business.• Establish quality policies and procedures based on company requirements and/or Compliance regulations and standards.• Coordinate with Business Unit Manages and Training Manager to provide feedback that will be useful in determining training requirements.• Identify ongoing opportunities for improvement and recommend potential training needs of Business Unit staff.• Provide feedback to management and leadership teams including Team Leads through group meetings, one on one coaching sessions and recommendation of activities/incentives for the staff .• Conduct ongoing random monitoring of staff through internal monitoring systems. and calibration sessions, provide feedback and co-create action plans with Managers and Team Leaders for continuous improvement.• Recommend and discuss potential training needs for staff and assist the with implementation of processes, when necessary. • Assist QA manager in the operation of the Quality Assurance team’s quality assurance programs• Assist QA manager in managing quality resources across all locations• Provide recommendations and assist in the implementation of a customer service call quality strategy and methodology• Provide monthly trending analysis reports to Business Unit Managers, Director’s and Team Leads• Collate, analyze and report performance data against defined parameters• Generate and assist in the implementation of a strategy to develop quality coaches and other appropriate company expertise for driving quality improvement• Provide innovative solutions to support the ongoing needs and future growth of the organization to ensure excellent customer service.• Works with Management Teams to ensure procedures are understood, executed, evaluated and tested• Facilitates daily/weekly calibration sessions across all Business Units and lines of business• Review monthly reports to include volume of incoming calls, type of calls, and a summary of trends of member complaints and reports findings to call center management and the Quality Improvement Compliance Committee (QICC)• Facilitate audit function of verification/education call process, in addition to other lines of business, to include requesting and evaluating wav files from NICE monitoring sessions and other operating systems• Work in conjunction with Compliance to ensure that staff adheres to client guidelines and departmental processes and procedures• Prepare call center plan data related to quality initiatives for client audits as requested and required• Obtain, file and distribute all documents from delegated entities per company guidelines• Travel to other locations, as needed.• Other duties as assigned Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Specific qualifications include, but are not limited to: • Expert knowledge of Business Unit’s daily function and quality standards• Ability to function in a rapidly changing and evolving work environment• Must have strong problem solving skills and be able to work independently to complete projects from start to finish. • Must be able to handle multiple priorities simultaneously.• Ability to build productive business relationships with peers, subordinates and customers.• Must be reliable and have excellent attendance. Must follow instructions given by members of the Management team. • Must be able to delegate tasks when applicable. Education and/or Experience: • Bachelor's degree in from four-year College or university or• Three to Five years related management/supervisor, quality and/or training experience in operations preferred• Experience working with or in a managed healthcare or Insurance environment preferred.• Excellent English verbal and written communication skills REQUIRED.• Understanding of US business culture REQUIRED.• Understanding of US Geography and Demographics REQUIRED.• At least two years prior experience working with computers and experience with Microsoft programs including but not limited to Word, Excel, PowerPoint and Visio and use of the Internet Certificates, Licenses, Registrations: AHIP and/or LOMA designations REQUIRED Language Skills:Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to write reports, business correspondence, and procedure manuals. Competencies: Integrity/Honesty, Interpersonal Skills, Oral/Written Communication, Teamwork, Organization/Planning, Motivation, Initiative. Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability:Ability to define and solve problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form and deal with several abstract and concrete variables.