Mgr, TRICARE Quality Assurance

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, , IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Manages the Quality Assurance operations for Tri West’s TRICARE Contact Center including internal Tri West Operations, as well as operational process and reporting for Tri West’s delegated contractors. Responsible for managing Quality Assurance supervisors and key performance metrics (KPIs) that contribute to ensure contract objectives success and customer satisfaction. Manages performance trends and partners with the Director of Quality Assurance to implement plans, strategies, and partnerships which ensure agent and delegated contractor performance, development and retention of talent.

Works with the director to build and administer Tri West’s Contact Center quality programs using Verint technology and scorecard reporting. Manages internal and partner compliance of policies and regulations with the leaders, calibrating calls and recommending improvements to foster accountability and engagement in Tri West’s performance. Leads or participates in improvement projects, performs cost/benefit analysis. Executes projects and initiates joint problem-solving using data analysis tools, performance measurements, and decision-making processes.

Assists with staffing, training, and developing staff to attain service-level requirements of the TRICARE program, in line with Tri West's contract policies and procedures.

Required:

• Bachelor’s degree in business, Communications, or related field or equivalent experience
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 5+ years’ experience in Quality Assurance leadership and/or or process improvement within the health care call center setting.
• 3+ years supervisory or leadership experience)
• Experience in planning, leading, and participating in major process improvement projects
• Strong knowledge of Quality Assurance principles and practices.
• Experience with Quality Assurance software and reporting tools;
  Verint preferred
• High Proficiency in Excel.
• Software Knowledge:
  Salesforce, Tableau/Power BI

Preferred:

• Master’s degree in Business or related field
• Knowledge of TRICARE program
• Experience with Six Sigma or other quality improvement methodologies

• • Designs and manages quality assurance programs to improve quality levels of the Contact Center and delegated contractors of Tri West,.
• • Develops ongoing metrics and monitoring processes to assess effectiveness and efficiency for continuous improvement.
• • Plans and designs performance systems supported by benchmarking, cost analysis, business cases, and other criteria. Participates in the implementation of systems designed to measure process and performance. Contributes to program governance, project reviews, cross-functional communications, training, and rewards programs.
• • Collaborates with Tri West management team to identify service issues and develop enhanced metrics. Contributes to quality projects. Evaluates case reviews to identify and address quality and service improvement opportunities.
• • Serves as a change agent to promote the development and integration of systems-thinking, customer focus, and commitment to continuous process improvement. Creates active change by facilitating issue identification, research, and cross-functional corrective action.
• • Partners cross-functionally to promote high-quality service levels throughout Tri West and its delegated contractors.
• • Partners with Tri West’s Training and Development and Knowledge Management leaders to provide recommendations to improve training curriculum and job aids
• • Manages daily operational resources, tracking results against requirements.
• • Supports the Quality Assurance supervisors in overseeing department staff, assigning and monitoring workflow
• •…