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Quality Professional - Remote US

Role overview

Summary

This role is for a CX Professional Quality at a remote position in the US, focusing on monitoring and evaluating the quality of customer interactions. You will support quality assurance initiatives that enhance employee, member, and client experiences while ensuring compliance with established standards.

Qualifications

  • Bachelor's degree or equivalent combination of education and experience.
  • Three or more years of quality assurance or subject matter expertise experience.
  • Demonstrated knowledge of two or more MMIS business areas.
  • Experience utilizing Microsoft Office suite and Salesforce software.
  • Effective written and oral communication and interpersonal skills.

Responsibilities

  • Monitor and evaluate the quality of inbound and outbound interactions.
  • Execute daily quality assurance reviews and process audits of business processes.
  • Participate in the planning, execution, and delivery of quality assurance initiatives.
  • Facilitate knowledge sharing and alignment with key stakeholders through engagement sessions.

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • English

Hard skills

Other skills

  • Quality Assurance
  • Microsoft Office
  • Communication
  • Social Skills
  • Organizational Skills
  • Time Management
  • Teamwork

About the company

Gainwell Technologies LLC logo

Gainwell Technologies LLC

  • GovTech
  • Large
  • 10,001+
For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus. Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies. Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.

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Job description

 

Summary

The CX Professional Quality is responsible for monitoring and evaluating the quality of inbound and outbound interactions. You will support our quality commitment of exceptional, accurate, and compliant execution of work through measurement, analysis, and review of agent and account calls and transactions and compliance, and of related business processes and surveys. You will be responsible for executing daily quality assurance reviews and processing audits: first-level reviews of business processes which involve reviewing documentation to ensure activities are in line with Account, CX and Company standards, policies, and procedures. You will participate in the planning, execution, and delivery of quality assurance related initiatives. Partnering with your immediate, centralized, and account team members, the work you deliver will drive improved employee, member, and client experiences and achievement of Account and company goals and objectives.

Your role in our mission

•    Regularly evaluate customer interactions (calls, emails, chat, transactions, etc.), to include complex interactions, to assess adherence to established quality standards and regulatory compliance requirements.
•    Embrace and utilizes procedural and technology automation to support the effective and efficient evolution of QA support.
•    Proactively engage to support, occasionally lead, and consistently add value in calibration sessions to deliver consistency in quality evaluations.
•    Facilitate knowledge sharing and alignment with key stakeholders through routine engagement sessions. 
•    Leverages adhoc reporting delivers results inclusive of key observations, recommendations, and trending to appropriate peer coaching to the various levels of leadership and applicable.
•    Strive to personally resolve or escalate unresolved issues to an appropriate level to include negative customer experiences.
•    Synthesize personal quality behavioral observations to inform insights and trending.
•    Make recommendations and suggest initiatives for process and policy enhancements based on data-driven insights.
•    Remain current with industry best practices for contact center quality assurance.

What we're looking for

•    Bachelor's degree or equivalent combination of education and experience
•    Three or more years of quality assurance or subject matter expertise experience - quality assurance principles, methodology and practices
•    Demonstrated knowledge of two or more MMIS business areas (Authorized Services, Member / Provider Contact Center Customer Service / Helpline, Mailroom, Pharmacy, Provider Enrollment, etc.) and experience partnering with operations staff assigned to multiple areas.
•    Experience utilizing Microsoft Office suite and Salesforce software contact center and back-office contract center operations (CXOne, Verint, SharePointe, etc.).
•    Effective written and oral communication and interpersonal skills to work effectively with team members, customers, and clients.
•    Demonstrated strategic initiative implementation and execution, specifically with operating policies and procedures and work process improvements in customer contact operations.

Additional Preferred Qualifications

•    Knowledge and experience of quality metrics and contact center quality technology platforms
•    Strong organizational and time management skills.
•    Skilled at working independently and as part of a team.
•    Demonstrated capability to embrace and implement change in personal workspace.

What you should expect in this role

    Fully remote position with the opportunity to work anywhere within the United States (review for accuracy)

We are accepting applications for this position until 11/30/2026.

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