Quality Auditor - Provider and Member Services
Firstsource
India
Thỏa thuận
Mô tả công việc
The primary purpose of this role is to monitor, analyze, and enhance service quality standards within a Patient Contact Center supporting healthcare providers. The Executive / Senior Executive – Service Quality is responsible for auditing provider and patient-facing interactions, evaluating adherence to quality frameworks, analyzing trends, and driving continuous improvement initiatives. The role serves as a subject-matter resource for provider contact center processes and associated quality measures, ensuring alignment with organizational goals, client expectations, and healthcare compliance requirements.
Skills
Skilled in using QA scores, error trends, handle time, and patient experience feedback to set training priorities
Collaborative mindset, partnering with Operations and Training to align performance gaps and new initiatives to meet quality standards
Ability to apply QA scorecards consistently across soft skills (empathy, tone) and hard skills (accuracy, compliance, call flow).
Experienced in Comfortable reviewing quality trends, CSAT, FCR, and error patterns to pinpoint root causes and recommend fixes
Ability to hear both what the patient says and how they feel, and recognizing where the call went off track.\
Evaluate calls through the lens of trust, clarity, and reduced effort for the patient or family
Scoring based on evidence, not opinion or relationships, and maintaining credibility with agents and leaders
Key Accountabilities / Responsibilities
Conduct regular quality audits of provider and patient-facing interactions across voice, email, and digital channels.
Analyze quality metrics at individual, team, and process levels to identify performance gaps and improvement opportunities.
Provide timely quality feedback through audits, side-by-side coaching, calibrations, and development sessions.
Develop and maintain a repository of monitoring results, audit scores, and feedback to support trend analysis and quality improvement.
Partner with Operations, Training, and Team Leaders to design and implement corrective action plans.
Support creation, review, and updates of quality guidelines, SOPs, scorecards, and calibration frameworks.
Ensure consistency and accuracy in quality evaluations by participating in calibrations and quality reviews.
Identify opportunities to expand the scope of the quality program including new metrics, tools, and reporting mechanisms.
Stay current with healthcare provider contact center best practices, quality methodologies, and regulatory requirements.
Act as a point of contact for quality-related clarifications, audits, and internal stakeholder discussions.
Perform other quality and process improvement activities as assigned.
Essential Knowledge & Skills
Strong experience in healthcare or patient contact center operations with a focus on service quality.
A clear understanding of what constitutes high-quality provider and patient interactions.
Ability to identify process gaps and opportunities for improvement.
Excellent verbal, written, and presentation skills with the ability to deliver constructive feedback.
Strong analytical and reporting skills with attention to detail.
Ability to effectively mentor and coach associates, including in remote environments.
Working knowledge of HIPAA and healthcare compliance standards (preferred).
Education, Experience and/or Training
Graduate or undergraduate degree preferred, or equivalent relevant experience.
Service quality or quality assurance experience in a contact center environment is required.
Prior experience in provider or patient contact center operations is preferred.
Strong proficiency in MS Office applications including Excel, PowerPoint, and reporting tools.
Personal Attributes / Behavioral Competencies
Customer-centric and quality-driven mindset.
Objective, fair, and data-driven decision-making approach.
Collaborative working style with cross-functional stakeholders.
Adaptability to changing healthcare processes and requirements.
High standards of integrity, confidentiality, and professionalism.
Kỹ năng
Địa điểm làm việc
Philippines
Quality Auditor - Provider and Member Services
Firstsource
India
Thỏa thuận
Mô tả công việc
The primary purpose of this role is to monitor, analyze, and enhance service quality standards within a Patient Contact Center supporting healthcare providers. The Executive / Senior Executive – Service Quality is responsible for auditing provider and patient-facing interactions, evaluating adherence to quality frameworks, analyzing trends, and driving continuous improvement initiatives. The role serves as a subject-matter resource for provider contact center processes and associated quality measures, ensuring alignment with organizational goals, client expectations, and healthcare compliance requirements.
Skills
Skilled in using QA scores, error trends, handle time, and patient experience feedback to set training priorities
Collaborative mindset, partnering with Operations and Training to align performance gaps and new initiatives to meet quality standards
Ability to apply QA scorecards consistently across soft skills (empathy, tone) and hard skills (accuracy, compliance, call flow).
Experienced in Comfortable reviewing quality trends, CSAT, FCR, and error patterns to pinpoint root causes and recommend fixes
Ability to hear both what the patient says and how they feel, and recognizing where the call went off track.\
Evaluate calls through the lens of trust, clarity, and reduced effort for the patient or family
Scoring based on evidence, not opinion or relationships, and maintaining credibility with agents and leaders
Key Accountabilities / Responsibilities
Conduct regular quality audits of provider and patient-facing interactions across voice, email, and digital channels.
Analyze quality metrics at individual, team, and process levels to identify performance gaps and improvement opportunities.
Provide timely quality feedback through audits, side-by-side coaching, calibrations, and development sessions.
Develop and maintain a repository of monitoring results, audit scores, and feedback to support trend analysis and quality improvement.
Partner with Operations, Training, and Team Leaders to design and implement corrective action plans.
Support creation, review, and updates of quality guidelines, SOPs, scorecards, and calibration frameworks.
Ensure consistency and accuracy in quality evaluations by participating in calibrations and quality reviews.
Identify opportunities to expand the scope of the quality program including new metrics, tools, and reporting mechanisms.
Stay current with healthcare provider contact center best practices, quality methodologies, and regulatory requirements.
Act as a point of contact for quality-related clarifications, audits, and internal stakeholder discussions.
Perform other quality and process improvement activities as assigned.
Essential Knowledge & Skills
Strong experience in healthcare or patient contact center operations with a focus on service quality.
A clear understanding of what constitutes high-quality provider and patient interactions.
Ability to identify process gaps and opportunities for improvement.
Excellent verbal, written, and presentation skills with the ability to deliver constructive feedback.
Strong analytical and reporting skills with attention to detail.
Ability to effectively mentor and coach associates, including in remote environments.
Working knowledge of HIPAA and healthcare compliance standards (preferred).
Education, Experience and/or Training
Graduate or undergraduate degree preferred, or equivalent relevant experience.
Service quality or quality assurance experience in a contact center environment is required.
Prior experience in provider or patient contact center operations is preferred.
Strong proficiency in MS Office applications including Excel, PowerPoint, and reporting tools.
Personal Attributes / Behavioral Competencies
Customer-centric and quality-driven mindset.
Objective, fair, and data-driven decision-making approach.
Collaborative working style with cross-functional stakeholders.
Adaptability to changing healthcare processes and requirements.
High standards of integrity, confidentiality, and professionalism.
Kỹ năng
Địa điểm làm việc
Philippines
Firstsource
Quốc gia
Philippines
Giờ làm việc
Thứ Hai - Thứ Sáu
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