Specialist, Care Advocate Quality Assurance

Accollade Care Advocate Quality Assurance (QA) Specialist

Transcarent and Accolade have come together to create the One Place for Health and Care, the leading personalized health and care experience that delivers unmatched choice, quality, and outcomes. Transcarent's AI-powered WayFinding, comprehensive Care Experiences - Cancer Care, Surgery Care, Weight - and Pharmacy Benefits offerings combined with Accolade's health advocacy, expert medical opinion, and primary care, allows us to meet people wherever they are on their health and care journey. Together, more than 20 million people have access to the combined company's offerings. Employers, health plans, and leading point solutions rely on us to provide trusted information, increase access, and deliver care.

Role Overview

As an Accolade Care Advocate Quality Assurance (QA) Specialist, you will be a key member of the Quality Assurance Team for our Care Advocates. You will be responsible for monitoring and evaluating client call interactions and associated documentation, documenting performance strengths and weaknesses using QA tools, providing feedback to Stewards utilizing audit results, and highlighting compliance, documentation and / or process issues. The primary focus of the role is to ensure consistency in service expectations and process standards are met among Health Plan Health Assistants, Care Advocates, Claims & Benefits staff, Health Care support staff, and other non-clinical employee interactions. With an eye toward continuous improvement of the client experience, you will ensure adherence to service expectations and process standards as well as provide ongoing feedback to key organizational partners on client satisfaction and client perception.

A Day in the Life...

• Monitor, evaluate, and score clients' interactions (e.g. calls, mobile messages) according to Accolade's defined internal standards.
• Utilize quality dashboards and other automated tools to provide analysis and insights into performance opportunities.
• Listen and research recorded calls to identify rationale for variances and inconsistencies in policy adoption among Care Advocate Center representatives.
• Review all documentation in client record associated with calls.
• Maintain a thorough understanding and ability to follow established process and procedures for Care Advocates and customers.
• Provide feedback and evaluation to Quality leadership regarding trends in variances of established policies, procedures, engagement models.
• Ensure call handling compliance with following up on member issues, conditions, contextual red flags and that the client is supported beyond their initial reason for calling.
• Based on call calibration analysis, recommend process and policy improvements to reduce costs and inefficiencies.
• Identify opportunities for development and work with Learning & Development to create customized learning opportunities.
• Consistently meet departmental expectations regarding productivity and calibration.
• Participate and complete all relevant training and education for Front Line Care Team employees to provide feedback and evaluations in compliance with.

What We Are Looking For...