Quality Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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CareMetx, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

CareMetx, LLC is a company that specializes in transforming patient access to specialty therapeutics by reducing the time to therapy. They offer a digital Hub service that addresses emotional, financial, and clinical barriers for patients, aiming to improve treatment timelines and ongoing therapy use. CareMetx provides high-touch support and utilizes advanced technology to offer solutions for access, affordability, and adherence, benefiting both patients and healthcare providers. They partner with specialty pharmaceutical brands, healthcare providers, and hospital systems to enhance patient outcomes.

📋 Description

• Monitor and document program performance in support of departmental goals and initiatives • Evaluate verbal and written interactions by program support staff • Work with Program Operations and Quality Management to design and update quality monitoring formats and standards • Review team interactions with internal and external parties for accuracy, service quality, and adherence to standards • Identify coaching, feedback, and education opportunities • Assist with developing and delivering reports on performance, trends, and actionable insights to Operations Leadership • Monitor interactions, support request processing, and electronic records for accuracy, policy adherence, and call-handling standards • Monitor and report adverse events, patient-identification nonadherence, off-label use, and provision of medical advice • Download and de-identify program interactions for review • Monitor program team and vendor-partner performance quality • Document evaluations using quality-monitoring templates, standards, and technology • Complete system, compliance, and process audits • Work with leadership to resolve disputes regarding compliance scoring or standards • Review written communications, including call notes, inbound SMS, and voicemails, for pharmacovigilance information • Participate in calibration meetings with QA, Training, and Operations Leadership • Provide periodic reports to management • Identify trends from quality evaluations and provide performance feedback to Operations leadership • Support the design and enhancement of quality-monitoring forms and standards • Maintain job knowledge through research, educational opportunities, publications, networks, and professional organizations • Research new contact-center QA monitoring technologies and methodologies and present findings • Maintain regular and reliable attendance • Perform other related duties as assigned

🎯 Requirements

• Preference for at least 2 years of experience performing quality assurance audits in a call center environment • 3+ years in a regulated industry with auditing or peer review experience preferred • Experience reading, interpreting, and enforcing SOPs and policies • Experience evaluating documents and voice recordings • Relevant healthcare, insurance, or telehealth experience with biologics • Training skills preferred, but not necessary • Bilingual or multilingual written and verbal skills desired, especially Spanish • Exceptional listening and analytical skills • Excellent attention to detail • Ability to manage competing deadlines and multiple projects in a fast-paced environment • Ability to work positively and productively as part of a team and independently • Ability to maintain confidentiality • Computer skills including word processing, spreadsheets, and general data analysis • Proficiency in Word, Excel, and PowerPoint for presentation and report development • Knowledge of reimbursement and/or patient assistance programs • Knowledge of HIPAA and pharmacovigilance regulations/standards preferred • Knowledge of customer care processes and techniques • Organization, professionalism, accurate documentation skills, and ability to comply with regulatory requirements • Excellent communication and interpersonal skills • Flexible, detail-oriented, and able to adapt to change • Compliance with laws, regulations, and policies governing CareMetx activities • Must be flexible on schedule and hours • Must regularly attend work reliably and on time • Willingness to provide support and coverage for fellow team members during planned and unplanned time off • Employee must occasionally lift and/or move up to 10 pounds • CareMetx considers equivalent combinations of experience and education

🏖️ Benefits

• Flexible schedule and hours • Minimal travel requested (<10% travel) • Reasonable accommodations for individuals with disabilities • Equal employment opportunity and nondiscrimination protections