Job Summary:

The Quality Assurance Analyst reports to the Operations, Quality Assurance Leadership (Operations, QA Director) and is responsible for collecting and analyzing data collected from various resources. Primary data will be collected from incoming evaluations that are completed by Operations Quality Assurance Associates. The QA Analyst will identify trends and opportunities for both program and agent performance and will communicate/present to CRx key stakeholders and clients. The QA Analyst will drive action-oriented solutions to all Crx cross-functional team members. The recommended solutions will be based on best practices within the industry and include the voice of the customer (VOC), and support data visualization tools with appropriate statistical methodologies. Additional functions will include acting as a mentor for the department by assisting with the training of new hires, participate in peer-to-peer coaching of Operations Quality Associates, recommend and lead process improvement projects, as well as lead cross-functional teams to facilitate program quality with both external and internal stakeholders.

Essential Functions

% of time (estimated) Essential Functions

1 40

Perform data analysis on data collected by Quality Associates to look for trends, insights, and areas of opportunity within programs and agent performance. Create slide decks and presents these documents to internal and external stakeholders alongside Operations Quality Assurance leadership. Uses the data to recommend process improvement opportunities and lead teams to action-oriented results. 2 30 Participate in meetings with Operations leadership and/or Clients to discuss program(s) Quality scores and areas of opportunity. Communicate identified trends, quality risks, and serve as a resource regarding quality concerns and continue monitoring for improvement opportunities.

3 10

Provide feedback to Operations Leadership and Operations Agents during coaching sessions, utilizing structured coaching methods. Explore Process improvement opportunities, initiatives, and remediation. Coach Operations Quality Associates as needed with peer-to-peer coaching; train new department hires and operation agents on program business rules and processes. 4 10

Complete evaluations on work completed by Operations agents to ensure that documented business rules, SOPs, WINs, etc. are adhered to during operational transactions, relevant compliance standards are met, while ensuring that all transactions support the goal of a Crx values to provide exceptional customer service for patients, healthcare providers, and customers.

5 10 Other duties as assigned

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function(s).



Knowledge, Skills and Experience: Identify up to 4 of the most important in each. State the minimum required.

Knowledge (concepts of the discipline) Acts as a Quality Assurance Analyst Subject Matter Expert.

Solid working knowledge of quality- oriented services such as accuracy management, performance metrics, customer experience/satisfaction, and SOP execution.

Strong background in the identification and execution of process improvement opportunities and initiatives.

Health Care Experience specifically claim processing, contact center, benefit verification, case management, and/or similar industry experience is required.

Call Center & / or Claim Processing experience is a plus.

Skills (level of measurable proficiencies) Prefer Lean Six Sigma certified at Green Belt level or higher.

Strong understanding of all Microsoft Office Products (Excel, Word, PowerPoint, etc..).

Very strong verbal and written communication skills to enable relationships across all levels of the organization.

Fluent in English/Spanish (a plus).

Knowledgeable, responsible, and self-driven to drive excellent customer service and strong patient outcomes.

Must have an extreme sense of patient/customer empathy- customer centric.

Education/Degree Requirements/Certifications (if applicable) Associate Degree or equivalent years of experience required.

Prefer Quality Certification such as Lean Six Sigma Green Belt (or higher)

Experience (number of years) for people management jobs, indicate years required managing people 2-5 years of process improvement and trained in the use of the statistical tools/reporting and preferably the techniques of Six Sigma.1 to 3 years in a quality assurance or quality auditing role preferably in a call center, claim operations, pharmacy hub, or similar environments.Core Competencies (key behaviors) Problem solving, results oriented, active listening, and high level of attention to detail.

Training Delivery, Adult Learning Principles, Teamwork, contributes to a positive team spirit. Attendance/Punctuality is consistently at work and on time; ensures work responsibilities are covered when absent.

Presents strong decision making and critical thinking skills.

Demonstrates ability to address conflict management, collaboration, and the development of others.

A strong understanding of empathy across multiple teams that supportl patient, client, and/or HCP interactions.

Ensure provision of exceptional customer service required in customer care case management engagement.

Work in a matrix environment requiring strong collaboration skills

Travel or Physical Requirements (if applicable):

Perform primarily sedentary work with occasional lifting to 20 pounds, and exerting up to 10 pounds of force occasionally, and a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

See, hear, talk, and perform tasks requiring visual acuity, manual dexterity, grasping and other similar tasks requiring physical activity and repetitive motions.

Operate standard office and computer equipment.