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About the Role

The 32BJ Health Fund seeks a Quality Assurance (QA) Analyst to provide technical assessments of member calls and notations in corporate systems made by Health Services staff. The QA Analyst will perform concurrent monitoring and assessment of phone calls, perform quality control on notes, and produce reports on audits, noting trends and making recommendations for improvement. This role identifies workflow deficiencies, reports them to management, conducts telephonic member surveys, and works on special projects.

Responsibilities

Perform concurrent monitoring/assessment and scoring of phone calls between 32BJ members and Patient Advocates (PA’s) to determine accuracy, professionalism, timeliness, telephone presentation skills, and responsiveness.
Perform quality control on the timeliness and accuracy of PA documentation in Microsoft Dynamics, vendor systems, and internal systems.
Analyze quality review results, performance metrics, and operational data to identify trends, recurring issues, root causes, and opportunities for process improvement.
Identify deficiencies, investigate reasons for errors, develop recommendations, and produce reports on findings for management review.
Identify training needs for PA’s and advise management on individual PA development.
Provide feedback to management on trends and processing errors indicating a system problem.
Identify exceptional PA performance and recommend employee recognition.
Assist in the development, maintenance, and enhancement of quality standards, audit tools, scorecards, procedures, and performance measurement methodologies.
Conduct telephonic surveys on Health Fund programs.
Support departmental audits, compliance reviews, and special projects focused on improving operational efficiency, quality outcomes, and the member experience.
Perform other duties as requested by Management.

Requirements

3+ years of experience in call center operations, healthcare operations, health services, or a related field.
Expert knowledge of internal corporate systems (Dynamics, Cisco, V3, etc.), the benefits offered by the Fund, and Health Services standard operating procedures.
Prior knowledge conducting call audits, quality reviews, and performance evaluations preferred.
Strong experience in member call and note taking requirements.
Demonstrates attention to detail, quality, and consistency.
Outstanding written, oral communication, and interpersonal skills.
Must be able to maintain the highest level of confidentiality and high credibility when assessing customer care protocols.
Embraces the mission, purpose, and vision of the 32BJ Health Fund.
Able to work both independently and collaboratively within a team-oriented environment while maintaining independent judgement.
Must possess superior ability to provide constructive support and promote positive morale.
Strong organizational and time management skills with the ability to manage multiple priorities.
Ability to remain objective, fair, and consistent when conducting quality reviews and evaluations.
Demonstrate a continuous and proactive mindset.
Speak, read, write, and understand English & Spanish required.
High reasoning ability.

Skills

Microsoft Dynamics
Cisco
V3
Call center operations
Healthcare operations
Health services
Quality assurance
Quality control
Performance metrics analysis
Process improvement
Auditing
Reporting
Member surveys
Written communication
Oral communication
Interpersonal skills
Confidentiality
Organizational skills
Time management
Spanish

Location

Multiple states
Washington, DC

Work Type

Exempt

Experience Level

3+ years of experience

Education Level

Associate degree or equivalent work experience in the healthcare industry preferred.

Benefits

Health benefits
Pension
Retirement Savings
Training
Legal Services

About the Company

Building Services 32BJ Benefit Funds (“the Funds”) is the umbrella organization responsible for administering Health, Pension, Retirement Savings, Training, and Legal Services benefits to over 185,000 SEIU 32BJ members.
Our mission is to make significant contributions to the lives of our members by providing high quality benefits and services.
We embody five core values: Flexibility, Initiative, Respect, Sustainability, and Teamwork (FIRST).
The Funds oversees and manages $11 billion of dollars in assets.
We use cutting edge technology such as: M365, Dynamics 365 CRM, Dynamics 365 F&O, Azure, AWS, SQL, Snowflake, QlikView, and more.
The 32BJ Health Fund is a multiemployer labor management fund that provides health benefits to members of SEIU Local 32BJ and their dependents.
The Fund is self-insured and responsible for efficiently managing its resources as it provides comprehensive coverage for approximately 200,000 people across multiple states and Washington, DC.
The Fund offers benefits for medical, hospital, prescription drug, vision, dental, short- and long-term disability, and life insurance.
The Health Fund is one of five benefit funds administered by the 32BJ Benefit Funds.
The Fund has embraced value-based plan design and innovative purchasing strategies that encourage participants to use healthcare models and programs that provide primary care and other cost-effective benefits, including the 32BJ Maternity Program and the 32BJ Health Fund Centers of Excellence for Joint Replacement and Weight Loss (Bariatric) Surgery.
The Fund operationalizes this strategy by actively managing its plans and provider networks and by investing in forward-looking policies that lower healthcare costs while maintaining quality of care.