Sales Operations Quality Analyst III

Job Summary:

Sales Operations Quality Analyst III is responsible for monitoring agent onboarding activities and ensure they align with communicated policies and procedures and comply with federal and state regulations.

Essential Functions:

• Plan and execute specific action plans to monitor agent onboarding activities
• Identify and communicate irregular trends, recommend possible improvement opportunities and proactively use analytic and research skills to identify areas of risk along with recommendations for remediation to leadership
• Develop communication methodology to share findings with the individual team members, and leadership, including required corrective actions associated
• Support Sales Operations and leadership with internal and external audit activities and data analytics
• Oversee and support, as needed, scheduled reconciliation of agent data within Agent Performance Management (APM, an SAP application) to ensure accurate agent commission transactions
• Review and score recorded sales calls for compliance and training opportunities
• Distribute and track completion of Regulatory Distribution Management (RDM) requests with responsible parties
• Monitor Third Party Marketing Organization (TPMO) websites for compliance with CMS and CareSource guidelines
• Act as subject matter expert on project teams and provide expertise on internal work groups/committees to support organizational initiatives ensuring deliverables are met
• Manage and support the maintenance and creation of Policies, Procedures and Standard Operating Procedures identifying impact and implications of changes
• Ownership of reports, crosswalks, training materials
• Conduct scheduled and ad-hoc data analysis for reporting to leadership and business partners as needed
• Provide exemplary customer service to internal and external customers
• First point of contact for agent onboarding process escalations, conducting root cause analysis
• Provide training, interpretation, education and guidance related to department processes and procedures to new team members
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree or equivalent work experience is required
• Five (5) years of experience in healthcare or managed care is required
• Five (5) years of customer service experience is required
• Five (5) years of experience in insurance compliance, audit or other assurance function, including writing policies and procedures is preferred

Competencies, Knowledge and Skills:

• Intermediate to advanced proficiency in Microsoft Office including Word, Excel and PowerPoint
• Skilled in using visual software
• Strong familiarity with healthcare operations and/or clinical concepts, practices and procedures
• Knowledge and understanding of internal and external audit functions and processes
• Demonstrable project management and process knowledge
• Exceptional oral, written and interpersonal communication skills
• Cross-functional team skills; ability to work in matrix environment as well as ability to work independently
• Highly team and customer oriented
• Effective critical thinking, problem solving and time management skills
• Effective in negotiation and maintaining positive strategic relationships
• Advanced attention to detail
• Ability to work within tight timeframes and meet strict deadlines
• Ability to drive multiple projects simultaneously

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business