Requirements for applicants
Bachelor’s degree in related field or equivalent experience. 3+ years of auditing and training experience in a managed care or healthcare setting. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects. Amisys and CCMS experience preferred.
Duties
Position Purpose: Oversee all aspects of member and provider services staff education and training, including quality call audits.
Oversee the daily work functions of the quality audit team
Investigate and resolve complex call center quality issues
Audit services calls for quality, accuracy and adherence to set standards
Analyze work flow issues and call audits and advise management of trends and recommend resolutions to improve call quality or integrity
Review, investigate and resolve inquiries regarding member services’ issues for internal and external customers
Train and retrain as needed, all Member and Provider Services Representatives on call procedures, practices, and policies
Collaborate with internal departments to ensure member satisfaction.
Working conditions
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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