The Role
Leads customer service teams by monitoring quality, productivity, schedule adherence, and policy compliance. Conducts call reviews, coaching, calibrations, trend analysis, huddles, and performance evaluations. Resolves employee concerns, supports technical issues, manages disciplinary documentation, cascades process updates, prepares operational reports, and ensures compliance with HIPAA, HITECH, URAC, and information-security requirements.
Summary Generated by Built In
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.
• 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 his Training/ Quality Managers.
Job title:
Job Description:
DUTIES & RESPONSIBILITIES:
Shift Management Function:
- Performs daily monitoring of CSAs quality & productivity metrics by utilizing reports and database available.
- Implements floor management policies in order to ensure adherence to service level agreements between clients.
- Ensures that CSAs scheduled for the day is accounted for.
- Ensures connectivity and proper functioning of systems/ equipment of the CSAs prior to the shift and reports to workforce, CT group and Operations Manager for the immediate repair/ replacement of defective unit.
- Answers questions while CSAs are on-line and provide assistance in cases of technical problems experienced by CSAs in their function.
- Ensures that coaching and huddle schedules on a daily basis are carried out.
- Ensures CSAs adherence to schedules – shift schedule and off the phone schedules.
- Ensures that Team Leader checklist is completed daily and submitted weekly to his/ her respective leader.
- Escalates issues to Operations Manager or Shift Manager.
- Accomplish monitoring requirements as needed.
Quality & Policies/Procedures Compliance Monitoring Function:
- Be able to provide timely and accurate updates to the CSAs thru scheduled coaching time and/ or ad hoc for Hotline behaviors and/or non-compliance errors.
- Be able to carry out process related activities within the prescribed turn-around time.
- Ensures that non-compliance errors are coached to CSAs within the turn- around time.
- Ensures that all monitored calls are reviewed within the turnaround time.
- Attends calibrations and alignment meetings with support groups (QA and/ or Training).
- Knows and follows existing internal and external processes of the program
- Be able to carry out disciplinary action documents on a timely manner.
- Ensures that CSAs adhere to work schedule.
Staff Development/Team Building Function:
- Be able to manage and resolve CSAs’ HR related concerns
- Be able to ensure high morale of the team by carrying out team bonding activities.
- Be able to coach CSAs and provide feedback on weekly performance as evidenced by a signed coaching log. Complete one-on-one feedback sessions with CSAs, which can include counseling for disciplinary purposes (Ensure high motivation with low disciplinary actions).
- Be able to cascade process/ product updates to CSA on a timely manner
- Be able to do trend/ call handling analysis on CSA’s calls for coaching and action planning.
- Be able to create specific Individual Development Plans for CSAs over a given period of time.
- Be able to effectively cascade internal & client-related policies and programs to CSAs on a timely manner.
- Be able to meet with team at least once a week to discuss issues and share best practices.
- Be able to identify team members who display potential for other positions within the company. Assign tasks or projects to further develop that potential.
Administrative Function:
- Generates individual semi-monthly Employee Attendance Records via Global ESS.
- Reflects approved changes on schedules.
- Be able to conduct yearly performance appraisals.
- Be able to investigate and validate violations to the Project Cigna Code of Conduct, recommends and serves corresponding disciplinary action.
- Be able to perform special assignments or handle projects as delegated by leaders.
- Be able to submit reports as needed:
- Weekly Coaching logs
- Weekly Huddle Agenda
- Weekly & Monthly Team Performance Reviews
- Yearly Performance Appraisal for each CSA
- IDPs for CSAs
- Monthly EXCEED Nominees
Others:
- Perform tasks assigned by the Shift Manager.
- Periodically conducts interviews and screening for agent positions.
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), HITECH Act & URAC.
Location:
Skills Required
- Monitor customer contact points, calls, quality standards, and productivity metrics
- Provide coaching, feedback, trend analysis, and individual development plans for customer service associates
- Manage shift schedules, attendance, service-level adherence, huddles, and team performance
- Conduct quality calibrations and collaborate with Operations, Training, QA, and clients
- Prepare coaching logs, performance reviews, attendance records, and compliance reports
- Handle employee concerns, disciplinary documentation, interviews, and team development activities
- Follow HIPAA, HITECH Act, URAC, and information-security requirements
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The Company
What We Do
Sagility is a technology-led healthcare operations and business process optimization partner serving payers and providers. It combines healthcare expertise with artificial intelligence, intelligent automation, analytics, cloud platforms, consulting, and BPaaS to streamline claims, membership, clinical, payment-integrity, provider-network, and revenue-cycle workflows across the healthcare ecosystem. Its goal is to reduce administrative costs, improve member and provider experiences, and support better clinical and financial outcomes.
