TriWest Healthcare Alliance hiring Supervisor, TRICARE Quality Assurance in Phoenix, Arizona, United States | LinkedIn (2024)

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We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job SummarySupervises team of Quality Assurance Analysts staff involved in the following functions; building, scoring, completing and calibrating telephonic and electronic quality assurance assessments; conducting data entry quality compliance assessments; tracking, trending and analyzing quality trends; partnering with operational leaders identify process improvement opportunities and focused training agendas; performing ongoing Quality Assurance staff development; partnering with TriWest’s delegated vendors to communicate and standardize quality monitoring and performance management to ensure a consistent customer experience in accordance with established DHA expectations. This position ensures completion of weekly and monthly call and data entry assessments for TriWest and delegated vendor operations. The Supervisor will collaborate with TriWest leaders and delegated partner leaders to ensure consistent processes are in place and there is timely education of existing processes and program changes. The Supervisor may initiate, lead or participate in inter-departmental operational quality improvement projects and supervises TriWest’s Quality Assurance Analysts. The Supervisor will ensure that process changes are communicated and incorporated into quality assessments whether systematic or manual.

Education & ExperienceRequired:

• Must be a U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Bachelor's degree in a related field or equivalent work experience
• A minimum of 2 years of experience in a leadership or supervisory role in a healthcare or call center customer service environment
• Proven experience in quality assurance, call monitoring, and performance evaluation
• Strong understanding of healthcare systems, regulations, and compliance requirements
• Proficiency in Microsoft Office, call center quality tools, SharePoint, and other relevant software applications

Preferred

• Certification in quality management (e.g. Lean Six Sigma) Health Care Operations Bachelor's degree in Business, or related field or equivalent experience
• Experience with using Verint’s software package to manage performance evaluations and agent quality scorecards
• TRICARE experience

Key Responsibilities

• Successfully complete TriWest training in support of performance objectives expected from TriWest Call Center staff to ensure all DHA quality and compliance expectations are met.
• Utilizing the Verint system, develops and implements quality assurance programs and processes to monitor inbound and outbound call interactions to meet TriWest’s customer service and quality commitments to its Beneficiaries, Providers, and DHA Personnel.
• Conducts regular evaluations and audits of calls to assess adherence to scripts, compliance with regulations, and overall quality of service.
• Provides guidance, support, and direction to a team of Quality Assurance Specialists.
• Conducts calibrations per DHA regulations to meet expected quality targets; Provides constructive and actionable feedback and coaching to delegated vendor leaders, TriWest internal department leaders and stakeholders based on quality assessment findings.
• Identifies trends, patterns, and areas for improvement in call quality and performance and develops action plans to address them.
• Collaborates with the Quality Assurance Manager and TriWest Contact Center leaders to establish and maintain quality standards and best practices for TriWest Contac Center personnel.
• Using data and best practices, identifies quality performance gaps and partners with TriWest’s Leadership and Training team to build training plans to address them.
• Holds meetings with TriWest’s delegated vendor leadership to make recommendations for resolving performance gaps. Assists the TriWest Quality Assurance Manager with remediation plans and expected follow up.
• Provides one-on-one coaching and mentoring to Quality Assurance Analysts to support their professional growth and development.
• Contributes to program governance, project reviews, cross-functional communications, training, and rewards programs.
• Serves as a change agent promoting development and integration of systems-thinking, customer focus, and commitment to continuous process improvement.
• Serves as subject matter expert on review committees and annual document reviews.
• Ensures quality check processes exist for quality assurance data before posted to official reports and scorecards.
• Partners cross-functionally to promote high-quality of Connect Listen Asses Solve Salute (CLASS) model and accuracy.
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• Delivers training and remedial coaching for direct reports to promote position specific performance improvement.
• Participates in special projects and meetings.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

CompetenciesCommunication / People Skills: Ability to influence or persuade others under positive or negative circ*mstances; adapt to different styles; listen critically; collaborate.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Knowledge of TriWest programs, quality assurance programs, needs analysis, and post-implementation measurements, quality tools and models; experience with data management, statistical analysis, performance measurement and monitoring, report design, presentation, and meeting facilitation; proficient with database software, Excel, Project, PowerPoint, Access, Visio, and other statistical tools.

Working ConditionsWorking Conditions

• Ability to cover any work shift
• Ability to work overtime, if needed
• Onsite: Works within a standard office environment
• Remote: Private and secure workspace and work station with high speed internet is required.
• Extensive computer work with prolonged sitting, wearing of headset, typing, speaking on a phone

Company OverviewTaking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do.Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!Our job is to make sure that America’s heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

BenefitsWe’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursem*nt
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Washington D.C. and Washington State residents: Approx. $82,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.