PHRN Quality Analyst

This role is responsible for driving adherence to the quality policy and quality objectives. This support member ensures that operations adhere to the business unit’s Service Quality Plan by performing the defined scope and duties in quality planning, quality assurance, quality control, quality reporting and quality improvement to drive superior stakeholder experiencePHRN Quality Analyst

Degree: Active PHRN license.

Experience:

2-year experience in any direct patient care such as but not limited to long-term care, home and community-based services, hospital/facility setting, case management, care management, and/or working with managed care organizations (may include Medicare and/or Medicare recipients), possibly through BPO healthcare (member) or Philippines setting.

Additional Preferred Qualifications:

• Experience working with elderly and/or chronically ill patients
• Experience conducting health assessments with patients
• Experience interacting with members of the healthcare team
• Experience assisting patients with health benefits and coordinating care
• Ability to utilize critical thinking skills

Performance Management

• Responsible 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 quality standards set by the company and the account management.
• Designs and implements reports to establish patterns and trends of quality issues as they may arise.
• Provides quantifiable data to all quality judgments that are made.
• Works with operations as an auditor as well as regulator of quality issues
• Works with Training and Operations to provide trend reports to address any issues that need refresher training
• Conducts calibration session with the client and with Operations
• Conducts product specific coaching sessions with the agents regarding trends and quality
• Responsible in releasing updates and training flashes to Operations and Training group
• Handles incoming calls and/ or escalated calls and meets telephone productivity standards 
• Follows other tasks and/ or offline tasks assigned by BE Manager

Process Improvement

• Offers suggestion for continuous improvement of processes and systems.

OTHERS

• Other tasks and responsibilities as assigned by his or her immediate superior

WORK AT HOME RESPONSIBILITIES

• Be familiar with and abide to all Sagility general security and Work @ Home security policies and procedures
• Be familiar with and abide by all client security policies and procedures required to protect customer data
• Maintain the security of the home work environment and protect the Sagility-provided assets, client system and data
• Ensure that all security related incidents are reported
• Shall work on the same internet connection that was tested during setup process. If changes are made to the current internet connection or router during the course of application or employment, employee will be required to notify the appropriate parties in advance and retest the connection to ensure the requirements are met.
• Must immediately report system performance problems or downtime to his/her manager and the local IT-SPOC

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.
• Ensures compliance to the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), and Utilization Review Accreditation Commission (URAC).

COMPETENCY REQUIREMENTS:

With Expert Competency Level on the ff.:

Communication Skills (Spoken) Communication Skills (Written) Customer Service Orientation Computer Literacy Passion For Excellence Working in Teams / Interpersonal Skills Work Organization Analytic Skills Presentation Skills Training Needs Analysis

Quezon City, Bridgetowne ZetaPhilippines