Quality Assurance

Company: Presbyterian Healthcare Services
Location: Albuquerque
Posted on: April 10, 2025

Job Description:

Overview Now hiring a Quality Assurance Outreach and Engagement Trainer The Quality Assurance Outreach and Engagement Trainer is responsible for developing training content and classes in relation to the outreach and engagement for HEDIS, Medicare Stars, Risk Adjustment HCC capture, and other initiatives. The position will be responsible for providing a wide variety of quality assurance audit support services and monitoring all aspects of omnichannel interactions with members supported by the Performance Improvement Outreach and Engagement Team. This position will work to improve the member experience through constant auditing, evaluation, training, and development of the Outreach and Engagement Team. Directly reports to the Manager of Quality PHP Performance Improvement. How you belong matters here. We value our employees' differences and find strength in the diversity of our team and community. At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members. Why Join Us Full Time - Exempt: Yes Job is based Rev Hugh Cooper Admin Center Work hours: Weekday Schedule Monday-Friday Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees. Ideal Candidate: Associate degree 3 years of healthcare and/or managed care organization experience Qualifications Associate degree. 3 years of additional experience in lieu of degree. 3 years of healthcare and/or managed care organization experience required. Experience in quality assurance/auditing or training role preferred. Responsibilities Monitor inbound and outbound interactions for adherence to compliance guidelines, adherence to internal processes and scripting, quality of the customer service provided and accuracy of information gathered and communicated. Identify improvement opportunities through accurately assessing and scoring interactions to identify training and process improvement opportunities related to support provided by the Outreach and Engagement Team. Provide assistance and mentoring to all Outreach and Engagement employees, as needed. Make recommendations for process and/or scripting changes to improve compliance, conversion, and performance. Assist in creation of quality related documents, to include policies, procedures, job aids and communications. Participate in quarterly calibration sessions with leadership. Work with management team to determine learning and training needs. Assess the development and performance needs of the target audience Develop and coordinate new employee orientation programs and ensure new employees have all necessary computer programs and equipment to be able to work on day one Perform routine quality checks on outreach and engagement activities within the systems used, such as scrubbing schedules in Epic Assist in pulling and communicating results of department performance to PHP Leadership Provide feedback to leadership regarding trends, potential process deficiencies, and provide potential solutions. Become a subject matter expert for each line of business and outreach effort. Provide real time feedback through y-jacking during live interactions. Collaborate with leadership to ensure consistency with audit procedures and documentation. Analyze customer feedback and employee metrics to identify trends, patterns, and areas for improvement. Generate reports, metrics, and score cards to track quality assurance performance and trends over time. Participate in onboarding processes. Support staff through monitoring and answering questions placed in Microsoft Teams channels. Special Projects: Work collaboratively with fellow staff to advance the outcomes of the Performance Improvement department by serving on relevant internal and external committees; Assists with special projects/assignments as requested by members of management. May be required to assist with supporting queues, based on business needs. All other duties as assigned Benefits All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $36.48/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs. Employment Type: Full Time

Keywords: Presbyterian Healthcare Services, Albuquerque , Quality Assurance, Other , Albuquerque, New Mexico