Quality Assurance and Training Coordinator-Medicare Advantage Plan, San Rafael, CA
CareCounsel (www.carecounsel.com) is a wholly-owned subsidiary of Stanford Health Care. By joining the CareCounsel team, you will make a positive impact on the member experience with navigation of the complex healthcare system. We are growing our Service Excellence department to support our Medicare Advantage Member Services Team through quality monitoring, workflow & process development, and training.
This job is in San Rafael, California.
- Develops and maintains Medicare Part C Member Services Policy & Procedures and Training Collateral that follows Medicare and HIPAA guidelines.
- Enforces best practices through monitoring and coaching of policy & procedures, workflows adherence, and patient-centered interactions
- Conducts member services training and support on best practices in alignment with agency policy, Medicare compliance and HIPAA compliance.
- Assists program leaders with Medicare audits
- Updates knowledge management systems to ensure consistency and timeliness with information sharing
- Performs other duties as assigned
We Would Like:
- Caring and compassionate nature with superior patient-focused customer service
- Member Services contact center experience in a fast-paced setting
- Substantial knowledge of Medicare and Medicare Advantage Plan compliance with regards to Part C Member Services
- Experience working in managed care, health benefits brokerage or other health benefits related environment
- Ability to navigate office productivity and CRM software applications
- Critical thinking and process development skills a must
- Excellent verbal and written communication skills required
- Team player, self-motivated, and possess the agility to meet changing demands
- Must be familiar with Medicare and Part C Member Services requirements
- 3 years’ work history within the healthcare industry
- Competency with Microsoft Outlook, Word, PowerPoint, Excel and Visio
- Familiarity with EPIC or other CRM applications
Please send cover letter and resume to firstname.lastname@example.org