Job Description

Description

The Quality Assurance Technician develops and implements programs to establish and maintain quality standards of existing products and services, as well as developing programs to focus employees on the quality of care given to patients. The Quality Assurance Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Quality Assurance Technician 2 develops policies, procedures and methods to check operational quality and improve same. Trains and/or coaches staff and management in areas such as quality improvement, process management and reliability science. Maintains communications with administration, medical staff and department heads regarding quality assurance activities. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Required Qualifications

* High School Diploma
* Proficiency in Microsoft Office Programs, including Word and Excel
* 1+ years of call center or claims processing experience
* Self-starter and able to succeed with minimal supervision or direct managerial oversight.
* Strong analytical and decision making skills
* Excellent verbal communication skills
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences
* Work At Home requirements (Temporary due to COVID-19): Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

* Familiarity and proficiency with internal Humana systems
* 1+ years experience in Healthcare and/or Medicare Advantage
* Associates Degree in health related field
* Bilingual English/Spanish. Candidate selected will not be communicating in English with members.

Additional information

* Schedule: Monday to Friday from 8 am to 5 pm,
* Training: 1 Month in San Juan 383 Ave. F.D. Roosevelt San Juan, PR 00918
* Work Location: This permanent job is working from Home temporary due to Covid 19 emergency. This position will deploy to the following location at a future date: San Juan 383 Ave. F.D. Roosevelt San Juan, PR 00918

Scheduled Weekly Hours

40