Sr Specialist, Medicare Member Engagement

Job Summary

The Quality Assurance Call Center Representative is responsible for monitoring and evaluating customer interactions to ensure that call center agents adhere to established quality standards. The role involves analyzing call recordings, providing feedback to agents, and collaborating with team leaders to enhance customer service performance. The ideal candidate is detail-oriented, with strong analytical and communication skills, and is committed to maintaining a high standard of customer satisfaction.

Key Responsibilities:

• Monitor and Evaluate Calls: Listen to and review Concierge call interactions to assess agent performance against quality standards, including communication skills, adherence to scripts, problem-solving ability, and overall customer service quality.
• Provide Feedback: Deliver constructive feedback to agents and team leaders, highlighting strengths and identifying areas for improvement. Work with agents to implement strategies for enhancing performance.
• Report and Document Findings: Accurately document evaluation results, creating detailed reports that capture key insights and trends. Present findings to management and make recommendations for training and development.
• Collaborate with Training Teams: Work closely with training teams to develop and implement training programs that address areas of improvement identified during call monitoring.
• Ensure Compliance: Ensure that all interactions are in compliance with company policies, procedures, and regulatory requirements. Report any breaches or potential risks to the appropriate authorities.
• Identify Process Improvements: Identify trends in customer interactions and recommend process improvements to enhance overall customer satisfaction and operational efficiency.
• Support Continuous Improvement: Participate in quality assurance calibration sessions with team leaders and management to ensure consistency in evaluation standards.
• Stay Updated: Keep up to date with industry best practices and emerging trends in quality assurance and customer service.

REQUIRED EXPERIENCE:

• 3-5 years’ experience working with the Medicaid population, preferably in an HMO or MCO setting, with experience in working with disabled, underserved and/or disadvantaged populations.
• MUST BE BILINGUAL IN SPANISH, MANDARIN/CANTONESE/VIETNAMESE OR KOREAN.

PREFERRED EDUCATION:

Bachelor's Degree in Social Work, Human Services or related field.

PREFERRED EXPERIENCE:

5+ years related experience

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

 

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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