Customer Experience Quality Control Trainer (QCT) – Care N’ Care Health Plan – Southwestern Health Resources (SWHR)

Customer Experience Quality Control Trainer (QCT) – Care N’ Care (CNC)

Care N ‘Care Health Plan is looking for top skilled Customer Experience Quality Control Trainer (QCT). Is that you?

Work location: Southwestern Health Resources Headquarters, 1601/1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work environment: Care N’ Care Health Plan Department.

Please note: The Customer Experience Quality Control Trainer (QCT) – Care N’ Care (CNC) will be an employee of Southwestern Health Resources (SWHR). SWHR is a clinically integrated network formed by Texas Health Resources (THR) and University of Texas Southwestern Medical Center (UTSW).

Work hours:

• Full Time; 40 hours per week; Rotating shift.
• Must work 8-hour shifts from Monday to Friday between 8:00am – 8:00pm (CST) from April 1st to September 30th during the year and from Sunday to Saturday between 8:00am – 8:00pm (CST) from October 1st to March 31st.
• This is a Hybrid position, requiring occasional onsite workdays based on department business needs.
• In-person attendance required at department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.

Organization Highlights

Southwestern Health Resources (SWHR) is a patient-centered, clinically integrated network of 31 hospital locations and more than 7000 physicians and clinicians caring for more than 790,000 patients across 16 counties in North Texas. Blending the strengths of Texas Health Resources and the University of Texas Southwestern Medical Center, SWHR offers an unmatched ability to connect individuals with a full spectrum of nationally preeminent, clinical care. SWHR is the parent of Care N’ Care Insurance Co., a leading regional Medicare Advantage health plan that serves North Texas seniors.

At SWHR, we believe healthcare can be more integrated, accessible and affordable for all. Our purpose: to build a better way to care, together. Our promise: to simplify and empower care, for good.

Here’s What You Need

Education

• High School Diploma or equivalent required.

Experience

• Require 2 years’ experience in Customer Service, Sales, Account Management, Quality Monitoring or Training experience.
• Require 1 year experience in Managed Care, Health Plan Operations, or Medicare.

Skills & Abilities

• Thorough knowledge of CMS guidelines, process and systems.
• Excellent problem solving and organizational skills.
• Strong interpersonal communication skills.
• Ability to work independently or as a team.
• Excellent knowledge of Microsoft Office (Excel, Word, PowerPoint).

What You Will Do

Position Responsibilities

Customer Experience Quality Control Trainer (QCT) is responsible for on boarding and deploying new staff of the Customer Experience Team as well as ongoing training and coaching as necessary or as regulatory guidelines are changed. By completing regular quality control monitoring activities of the team, the Quality Control Trainer will identify and report trending matters for training and process improvement as well as document processes for training purposes and service success of the Customer Experience Team.

Position Functions

• Must maintain a strong understanding of all Customer Experience team processes and procedures and identify and report trends in gaps by call monitoring evaluations and satisfaction.
• Responsible for suggesting and assisting with implementing methods to improve efficiency and service to both internal and external customers and may participate in process and training documentation development.
• Meets weekly with team leadership offering suggestions for gaps identified within call monitoring and evaluations. Communicating successes and areas for strengthening service and resolution for member population, prospective members, agents and healthcare provider experience.
• Provide training to staff for member population, prospective members, agents and healthcare provider education and counseling on access to services, benefits and providers recognizing areas for strengthening customer service and accuracy through team interaction and positive motivational methods.
• Assume ownership and responsibility for member population, prospective members, agents and healthcare provider satisfaction with Care N’ Care by identifying and implementing efficient training methodology and streamlined processes for improvement.
• Assistance with daily tasks as necessary for maximum performance of business operations including answer incoming phone calls from active member population, prospective members, agents and healthcare providers (i.e. physician offices, clinics) and identify the type of assistance the caller needs (i.e. benefit and eligibility, claims, billing and enrollments, prior authorization status, pharmacy inquiries, etc.) Maintain personal metrics to established performance levels of the team. Responsibilities may vary depending on seasonal business needs.

Why Southwestern Health Resources

As a Southwestern Health Resources employee, you’ll enjoy, comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.

• Additional perks of being an SWHR employee:
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Positively impact patients’ quality of life.
• Receive excellent mentorship, comprehensive training and dedicated clinical and administrative leadership resources.
• Enjoy opportunities for growth.

Explore Southwestern Health Resources Careers for more information and to search all career opportunities.

Our Recruitment team invites you to contact us with any questions at [email protected]