Quality Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and document program performance to align with departmental objectives and initiatives.

• Assess verbal and written communications from program support personnel.

• Collaborate with Program Operations and Quality Management to create and refine quality monitoring formats and standards.

• Evaluate team interactions with both internal and external stakeholders for precision, service quality, and compliance with standards.

• Recognize opportunities for coaching, feedback, and educational development.

• Aid in the creation and presentation of reports on performance metrics, trends, and actionable insights to Operations Leadership.

• Supervise interactions, support request processing, and electronic records to ensure accuracy, adherence to policies, and call-handling standards.

• Track and report adverse events, instances of patient-identification noncompliance, off-label usage, and the delivery of medical advice.

• Download and anonymize program interactions for further analysis.

• Evaluate the performance quality of the program team and vendor partners.

• Record evaluations utilizing quality-monitoring templates, standards, and technology.

• Conduct system, compliance, and process audits.

• Collaborate with leadership to resolve discrepancies related to compliance scoring or standards.

• Review written communications, such as call notes, inbound SMS, and voicemails, for pharmacovigilance insights.

• Engage in calibration meetings alongside QA, Training, and Operations Leadership.

• Provide periodic performance reports to management.

• Analyze trends from quality evaluations and deliver performance feedback to Operations leadership.

• Support the development and improvement of quality-monitoring forms and standards.

• Keep up-to-date with job knowledge through research, educational opportunities, publications, networks, and professional organizations.

• Investigate new contact-center QA monitoring technologies and methodologies, presenting findings accordingly.

• Maintain consistent and reliable attendance.

• Carry out other related duties as assigned.

⛳️ Requirements

• Preference for a minimum of 2 years' experience conducting quality assurance audits in a call center setting.

• Over 3 years of experience in a regulated industry preferred, with auditing or peer review experience.

• Familiarity with reading, interpreting, and enforcing SOPs and policies.

• Experience in evaluating documents and voice recordings.

• Relevant experience in healthcare, insurance, or telehealth, particularly with biologics.

• Training skills are a plus, though not mandatory.

• Desired bilingual or multilingual proficiency, especially in Spanish, for written and verbal communication.

• Outstanding listening and analytical skills.

• Exceptional attention to detail.

• Capability to manage competing deadlines and multiple projects in a dynamic environment.

• Ability to work effectively and efficiently both as part of a team and independently.

• Commitment to maintaining confidentiality.

• Proficient computer skills, including word processing, spreadsheets, and general data analysis.

• Competency in Word, Excel, and PowerPoint for report and presentation development.

• Understanding of reimbursement and/or patient assistance programs.

• Preferred knowledge of HIPAA and pharmacovigilance regulations/standards.

• Familiarity with customer care processes and techniques.

• Strong organization, professionalism, precise documentation skills, and adherence to regulatory requirements.

• Excellent communication and interpersonal abilities.

• Adaptable, detail-oriented, and capable of adjusting to changes.

• Compliance with laws, regulations, and policies governing CareMetx activities.

• Must be flexible regarding schedule and hours.

• Regular and punctual attendance is essential.

• Willingness to provide support and coverage for team members during both planned and unplanned absences.

• Occasionally required to lift and/or move up to 10 pounds.

• CareMetx acknowledges equivalent combinations of experience and education.

🏝️ Benefits

• Flexible scheduling and working hours.

• Minimal travel required (<10% travel).

• Reasonable accommodations available for individuals with disabilities.

• Equal employment opportunity and nondiscrimination protections.