Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
General Purpose:
At Central Health Plan, a Bright HealthCare company, the Auditor will perform regular internal quality control through phone monitoring and audits of Member Services calls; all findings will be reported to Member Services Manager to implement corrective action and focused training/education. As needed, auditing will also be performed for specific key first tier downstream entities to ensure the subcontractors are compliant.
Duties and Responsibilities:
Assess the quality and accuracy of calls or other member communications within the Member Services department
Perform detailed audit of call recordings and call log documentation; identify best practices as well as potential issues and findings
Document auditing and monitoring results with a detailed scoring system and communicate with employees verbally and/or in writing about improvement opportunities
Act as a subject matter expert on plan products and procedures to ensure that CSRs are providing accurate information and quality service
Prepare call center reports for management
Work closely with Appeals & Grievances and Compliance to retrieve call recordings, call log documentation, and any other records needed to support complaint resolution and/or internal/external auditing
Perform other duties, projects, and actions as assigned
Qualifications:
Bachelor’s degree in related field or equivalent experience is preferred
Minimum 2 years experience in call center operations or quality assurance, or equivalent experience
Strong attention to detail and ability to work independently
Bilingual skills in Mandarin/Cantonese REQUIRED
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
