Associate Quality Manager - Case Management Programs

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2 Locations
In-Office
Healthtech • Consulting
The Role

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

This role ensure adherence to Quality framework for existing scope and deploy the framework for existing programs or any new ramp ups. identify the internal pain areas in client processes and build robust controls around them.

Job title:

Associate Quality Manager - Case Management Programs

Job Description:

Education:

  • Registered Nurse, preferred but not required

  • Bachelor's Degree in related field from a four-year college or university

  • Minimum 2 years experience as a QA Lead preferably in the BPO industry

  • Advance experience with quality audits and audit hosting

Experience:

  • Minimum 3-4 years experience as a Quality Lead

  • Must be a regular and certified employee in their current role

  • Has no disciplinary action for the past 6 months.

  • Must meet a minimum of 10 out of 12 months on all KPIs with outstanding attendance record.

  • No critical Incidents reported

  • With Good Communication, Presentation, Interpersonal and Analytical skills

  • Experience on actual analysis is a plus

  • Preferably with strong Healthcare background

  • Must have the ability to engage and influence people across levels of the organization

  • Able to drive change and manage team performance

  • Willing to be assigned to Iloilo or Manila

Mandatory Skills:

  • Excellent communication skills, both written and verbal. Ability to effectively present information to internal and external associates

  • Demonstrated ability to organize and prioritize projects in a fast-paced and deadline-oriented business environment

  • Demonstrated ability to mentor, coach and provide direction to a team of employees

  • Demonstrated ability to take initiative and ownership with focus on continuous improvement

  • Demonstrated ability to foster customer service disposition and sense of professionalism for self and team

  • Solid understanding of the organization's business operations and industry.

Preferred Skills:

  • Lean Six Sigma Green Belt Certified

Roles & responsibilities:
Performance Management

  • Ensures that the Business Excellence Team meets standards for monitoring in an objective fashion all customer contact points. (Web, voice, e-mail, white mail)

  • Responsible for reporting all behavior that does not conform to the client standards set by the company and the account management.

  • Designs and implements reports to establish patterns and trends as they may arise.

  • Able to provide quantifiable data to all quality judgments that are made.

  • Works with all Operations and Support Groups to drive change and improvement

  • Engage in on-going communication with the account and business partner, acting as quality liaison to resolve outstanding quality issues, provide audit follow-up, and ensure customer satisfaction with the vendor's quality systems

  • Review and approve process and QC documentation to release processes for distribution

  • Recommend the six sigma & lean projects in the organization

People Management

  • Handles and resolves resistance of the team to change as it involves conflicting views and opinions.

  • Develops and trains team members through coaching, providing work advice and motivation.

  • Handles and resolves inconsistency of the team to change as it involves conflicting views and opinions.

  • Conducts meetings; Expands knowledge through seminars and keeping abreast of current quality issues.

  • Develops and trains team members through coaching, providing work advice and motivation.

  • Interviews and staffs QA team, internal and external candidates.

  • Conducts performance reviews and appraisals for Team Leaders (monthly/midyear/yearly).

  • Reviews preliminary investigation of disciplinary cases and approves/disapproves/escalates disciplinary actions in adherence to the provisions of the Company Code of Conduct.

  • Capability to train and conduct workshops in Six Sigma, Kaizens, Lean training etc.

  • Conduct & mentor GB and PCS projects

Process Improvement

  • Leads and guides Business Excellence Leaders in identifying proactive initiatives for business process improvements

  • Recommends corrective services within client limits to adjust customer complaints.

  • Provides continuous improvement of processes and systems.

The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned.

Location:

Quezon City, Bridgetowne ZetaPhilippines

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The Company
HQ: Westminster, Colorado
9,623 Employees

What We Do

Sagility is a U.S.-based, tech-enabled healthcare business process management company that supports payers, providers, and their partners to deliver best-in-class operations, enhance the member and provider experience, improve the quality of care and promote health equity all while delivering cost-effective healthcare financial and clinical outcomes.

Sagility Technologies uses a holistic consulting approach to identify the root causes of healthcare payer and provider pain points, analyze the issues, and provide a complete solution that encompasses people, process, and technology platform improvements. Equipped with a strategic solutions mindset, our core focus is on what most benefits the client. Combining healthcare operations and technology experience with advanced UI, UX, and analytics expertise, we develop and deploy customized solutions for our client’s business. Additionally, with our extensive global resources and facilities, we provide the best service/price ratio for any service outsourcing needs.

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