Manager Customer Service Quality - Geisinger Health Plan
Job Summary
Accountable for the development and implementation of quality strategies, plans, and processes to support organizational goals. Accountable for development of and ongoing compliance with NAIC (National Association of Insurance Commissioners) Model Audit Rule (MAR) requirements as they relate to all Customer Service Operational functions. Assesses quality needs as well as design, develop, deliver and maintain quality programs for onsite and remote employees. Provides direct supervision, oversight and development of staff.
Job Duties
- Develops and coordinates the execution of all Model Audit Rule requirements.
- Develops internal control procedures, and compliance reporting plans.
- Evaluates reports and findings with management and staff of all affected departments.
- Coordinates remediation efforts.
- Conducts quality needs analyses and consults key stakeholders to identify additional training needs.
- Determines key learning objectives which effectively describe outcomes of training and aid in the evaluation and measurement process.
- Identifies quality resources and innovative approaches that can be used to accomplish learning objectives.
- Coordinates external regulatory and vendor audits.
- Coordinates sample pulls, auditing of samples and acts as liaison when entities are conducting an on-site or off-site audit.
- Creates and utilizes quality evaluation tools that measure the effectiveness of training and the work being done on the floor.
- Evaluates quality programs and courses in an effort to identify how individual development needs are being met, and make recommendations for ongoing requirements of training and quality programs.
- Designs, develops, and delivers programs and materials relating to new hire on-boarding, product, system, soft skill, and organizational development.
- Selects, develops, motivates, trains and retains a competent staff to ensure appropriate staffing resources; perform annual staff performance reviews.
- Coordinates all quality activity; maintains quality audit schedule, resources and materials.
- Partners with internal department and vendors to stay abreast of new technologies, products, and trends to keep audits applicable and current.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
*Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).
#LI-REMOTE
Education
High School Diploma or Equivalent (GED)- (Required)Experience
Minimum of 9 years-Relevant experience* (Required), Minimum of 5 years-Managerial/Supervisory (Required)Skills
Manages Projects And Functions; Builds Relationships; Computer Literacy; Manages Conflict And CrisisAbout Geisinger
Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
Our Vision & Values
Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our Benefits
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.
A place where you can lead a healthy lifestyle and follow your dreams.
Only at Geisinger.
Best employer for healthy lifestyles – National Business Group
Access to 121 state parks
