Quality Review & Audit Analyst

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Pigtown, Center, OH, USA
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.

As a Quality Review and Audit Analyst you will work with varied members of leadership and clients and will serve as the point of contact for all quality related concerns. You will utilize your technical expertise to identify opportunities to streamline processes and/or adherence to SOPs or processes.  The role will require strong analytical and facilitation skills for presentation purposes. Excellent communication skills and the ability to influence are key.

Job title:

Quality Review & Audit Analyst

Job Description:

Education :

  • High School Diploma or G.E.D. required

  • Six-Sigma green belt training helpful

Experience:

  • 2+ years’ customer service experience required

  • Previous experience with high quality performance and review parameter

  • Working knowledge of Microsoft Office applications

Mandatory Skills:

  • Excellent organizational and planning skills

  • Excellent written and oral communication skills

  • Excellent interpersonal skills and professionalism

Preferred Skills:

  • Experience analyzing and interpreting data and recommending solutions

  • Strong analytical and organizational skills preferred

  • Detail oriented

  • Ability to manage multiple priorities and deadlines

  • Excellent communication skills, both written and verbal

  • Ability to function in a production environment while maintaining high quality results

  • Ability to make sound, independent judgments and decisions

  • Ability to influence others through the use of data

  • Experience analyzing and interpreting data and recommending solutions

  • Strong analytical and organizational skills preferred

  • Detail oriented

  • Ability to manage multiple priorities and deadlines

  • Excellent communication skills, both written and verbal

  • Ability to function in a production environment while maintaining high quality results

  • Ability to make sound, independent judgments and decisions

  • Ability to influence others through the use of data

Roles & responsibilities :

  • Review calls, emails, and chats for accuracy and identify opportunities analyze trends from call listening sessions, Identify and recommend improvements in processing and procedures and assist in the development of audit guidelines

  • Act as a subject matter expert and a resource for team members

  • Actively engage in quality initiatives to address error trends and process improvement

  • Facilitate national and site level calibrations and client calibrations,

  • Use various tools, methods and information sources to create analyses that identify any customer service deficiencies

  • Utilize the results of the above analyses to champion and coordinate remediation or proactive initiatives to improve quality

  • Serve as SME for technical questions and works to ensure standards are being met

  • Represent the team in internal and external audits

  • Drive the success of quality performance by identifying key opportunities to improve process flows and recognizing potential knowledge gaps at the individual/site level

  • Assess problems with client or systemic processes to mitigate any impact to our members.

  • Observe Supervisors’ scoring and provide findings to ensure scoring consistency

  • Conduct test calls, focus groups, and targeted audits or call monitors as necessary to identify trends and opportunities for quality improvements in a complete, accurate, and timely manner.

Location:

Quezon City, Bridgetowne GBF Center 1Philippines

Sagility Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sagility and has not been reviewed or approved by Sagility.

  • Healthcare Strength The company provides medical, dental, and vision coverage along with life insurance, short- and long-term disability, Flexible Spending Accounts, and an Employee Assistance Program. Policies also indicate coverage for dependents according to local regulations and include wellness and mental health initiatives.
  • Retirement Support A 401(k) with employer contribution is part of the standard package. Role descriptions and materials consistently reference retirement plan access alongside other core benefits.
  • Leave & Time Off Breadth Paid time off is provided, and formal leave types include maternity, paternity, adoption, and bereavement in line with local regulations. Additional flexibility elements such as hybrid or work-from-home arrangements are noted in some contexts.

Sagility Insights

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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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