Cigna Provider ILO - Quality Lead

Operation Support

Cigna Provider ILO - Quality Lead

DUTIES & RESPONSIBILITIES:

Performance Management: 

Quality-related tasks:

• Ensures analysts meet standards for monitoring in an objective fashion all customer contact points (Web, voice, e-mail, white mail.)
• Ensures analysts meet standards for evaluating surveyed calls, such as but not limited to the following:
  • Detractor and Passive rated surveys are evaluated by the analysts correctly/accurately and in a timely manner
  • Evaluations are based on customer survey verbatim and call listening
  • Evaluations are encoded in a central repository, summarizes, and analyzed
  • Provide actionable insights for Operations and Training use
  • Identify customer’s contact reasons and pain points/ sentiments
  • Identify all controllable (people) and non-controllable (process & systems) opportunities
  • Call out any mismatch between survey verbatim and call listening
  • Ensure behavior that does not conform to CSAT standards set by the company and the account management is reported
• Monitor and control the analysts on Productivity and Attendance related issues.
• Prepare fortnightly plans for Quality Analysts.
• Designs and implements reports to establish patterns and trends of quality issues as they may arise.
• Able to provide quantifiable data to all quality judgments that are made.
• Works with operations as an auditor as well as regulator of quality issues.
• Provides coaching tips and materials to Operations to enhance product knowledge, system navigation and soft skills.
• Maintaining Agent wise Error Trend Reports for the process and discussing about the plan of action with operations on a monthly basis.
• Maintaining documents related to Internal and External Audits.
• Maintaining Consolidated Reports for processes.
• Conducts client presentation regarding quality procedures.
• Responsible in maintaining all QA related documents. (i.e. ISO docs.)
• Provides updated, accurate and timely reports as required to the Manager.
• Works with Operations and Training in achieving quality objectives
• Work on quality audits and quality feedback per the set quality norms and guidelines for the process
• Highlight & facilitate key areas of operational improvement, leading to improvement in Key Client Metrics & SLA's.
• Drives Quality and CSAT culture in the team and make quality as a way of life.
• Assist team members in meeting/exceeding targets through knowledge sharing.
• Ensure process compliance standards as defined.
• Overview Quality score rebuttals with Operations
• Master calibrator for the process and participates in calibration sessions.
• Coordination of Quality induction for New Hires.
• Active participation in IJP’s for the Quality department.
• Attend client meetings weekly and as scheduled.

People Management:

• Handles and resolves inconsistency of the team to change as it involves conflicting views and opinions.
• Conducts Quality meetings. Expands training knowledge through seminars and keeping abreast of current quality issues.
• Develops and trains analysts through coaching, providing work advise and motivation. Also includes counseling for disciplinary actions.
• Communicates account overall quality performance to Operations Manager.

Process Improvement:

• Provides continuous improvement of processes and systems.
• Conducts process improvement plan and quality communication with the client handled, operations and training management.

Others:

• Perform tasks assigned by his/her immediate Head.
• Actively assist in maintaining operational excellence on critical metrics such as service levels.
  • Render phone time as required/scheduled and when needed to help with Operations’ service levels, call volume, etc.).

General Safety and Security

• Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS)
• Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions
• Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA) – For Healthcare Accounts

COMPETENCY REQUIREMENTS:

With Moderate Competency Level in ff.:

• Communication Skills (Spoken)
• Communication Skills (Written)
• Customer Service Orientation
• Computer Literacy
• Job Knowledge
• Sense of Urgency
• Passion for Excellence
• Working in Teams/Interpersonal Skills
• Work Organization
• Drive for Results/Execution
• Thriving in Change
• Expertise/Analytical Skills
• Product Knowledge
• Typing Skills
• Problem Solving
• Training Needs Analysis
• Process Improvement
• Performance Management
• Discipline Management
• Change Management

With Expert Competency Level in ff.:

• Expertise/Analytical Skills 

OTHER REQUIREMENTS:

Reports to: 

Quality Associate Manager / Manager

Supervises:

Quality Analysts / Customer Experience / Process Improvement Analysts

Essential Qualifications: 

Preferably any 4-yr College Degree and/or equivalent experience, 1-2 years call center experience and call monitoring.

Work environment:

The work environment is professional, office. Business casual attire.

Work at Home:

• Ability to create and follow business plans
• Time management skills
• Be reliable and responsible
• Organizational skills
• Willingness to seek help and ask questions
• Adaptability and Flexibility
• Self-Motivated
• Technically proficient
• Ability to work independently
• Proactive
• Ability to work as part of a virtual team
• Strong written and verbal communication skills
• Reliable home office equipment and internet connectivity
• Excellent problem solving skills
• Ability to work with little supervision
• Strong work ethic; Integrity

Physical demands:

May require weekend or evening work

Iloilo, Cybergate, PaviaPhilippines