Summary. The Quality and Compliance auditor coordinates and evaluates activities aimed at maintaining regulatory and contractual compliance and improving quality of service in the domains of clinical care, member/provider satisfaction, and plan operations, including development of policy and procedures. Essential Job Functions. Coordinates the development and maintains a quality management plan to address monitoring of compliance and quality metr...
Summary. Primarily responsible for providing members with exceptional customer service in an inbound call center environment. Provide accurate and efficient member services as part of call center to ensure that member’s services are delivered in a timely manner. Responsible for all documentation of member contacts received through Member Services in Electronic Health Record. Creates and processes non-emergent medical transportation service author...
