Customer Care Policy & Quality Analyst

Location: Remote

Position Summary

The Customer Care Policy & Quality Analyst serves as subject matter expert to ensure general understanding and awareness of Regulatory Policies and Compliance standards within the department and ensure all policies and procedures are adhered to.

Position Responsibilities

• Deeply embedded and collaborating with subject matter experts to identify and develop necessary policies, procedures, job aids, and training materials utilized by the Customer Care department and other departments within the organization.
• Research and maintain a comprehensive understanding of regulatory and compliance standards to ensure policies and procedures align with those standards within the Customer Care department
• Serve as subject matter expert to ensure general understanding and awareness of Regulatory Policies and Compliance standards within the department and ensure all policies and procedures are adhered to, including, but not limited to, HIPAA, Patient Safety and Security, Human Resources, Operations, etc., and any known infractions are communicated to the proper management immediately.
• Using available data and observations within each program or initiatives of the Customer Care department, participate in and influence the processes used in quality management, training, and coaching sessions. Additionally, suggest process improvement programs or initiatives and ensure that they are reflected in department written policies.
• Review reports and data to identify trends and ensure value added to CSAT analytics, methods, and practices are provided to operation.
• Assess whether agents are demonstrating proper procedures and an efficient and effective practice to provide excellent customer service and support.
• Support the onboarding process for new employees by using quality metrics, call monitoring, and observations to identify and address areas needing further training.
• Accurately perform evaluations on recorded and live agent calls and score them against the expected Customer Care standards.
• Facilitate Quality Assurance calibrations with operations to ensure evaluations are completed accurately across the board.
• Handle calls for various skills within the Call Center to stay abreast of our product and policies.
• Perform other duties as assigned by supervisor or other members of management, within deadlines provided.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
  
  

Minimum Qualifications

• 4+ years’ experience with call center operations, with at least 2 years of experience with Policy Writing and quality assurance.
• Bachelor’s degree preferred, or equivalent experience.
• Knowledge of HIPAA and Privacy Rule regulations.
• Strong ability to analyze call data and other metrics to identify trends, issues, and areas for improvement.
• Self-motivated and detail-oriented problem solver.
• A self-starter with outstanding customer service skills and dedication to providing exceptional customer care in a changing, fast-paced, and remote or hybrid environment.
• Demonstrate aptitude to develop people and processes.
• Ability to give and receive constructive feedback.
• Excellent verbal, written, and interpersonal communication skills.
• Strong analytical and organizational skills with an ability to carry out responsibilities with little or no supervision.
  
  

Preferred Qualifications

• Previous experience working with Salesforce and cloud-based CX platforms preferred.
• PBM or Healthcare call center operations experience preferred.
  
  

Base Salary: $70,000 - $75,000

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.