Healthfirst

The Field Service Auditor is responsible for performing Internal Quality Assurance Audits of Operational processes for internal employees and outsourced vendors to ensure compliance with policies, procedures and quality standards. The incumbent will investigate, audit, conduct root cause analysis, handle processing of determinations, track and trend findings. The individual at this level will embody Healthfirst’s Culture Drivers through his/her workplace behavior and works under minimal supervision.

Duties & Responsibilities: 

• Monitor Field Service Agents during encounter with members to determine quality standards are being met including improvement of the overall member experience.

• Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance.

• Ensure agents are appropriately identifying, researching, and resolving customer issues using appropriate methods and tools while effectively managing face to face encounters.

• Present results of investigations and error trends to leadership staff through written reports, dashboards, etc.

• Identify defects and improve departmental performance by supporting quality, operational efficiency and production goals.

• Meet established time frames and rates of performance for the quality and quantity of work for the position.

• Assist in the development of departmental policies and procedures; review the effectiveness of existing training.

• Work a flexible schedule, nights, weekends, and/or holidays with limited notice.

• Travel is required to multiple sites.

• Additional duties as assigned.

Minimum Qualifications:

• Experience working as a Field Service or Call Center Agent

• Ability to multi-task, prioritize, and manage time effectively.

• Communicate effectively verbally and in writing while demonstrating good grammar, spelling and punctuation skills.

• Strong active listening skills

• Experience in Microsoft Office suite of applications including Excel (formatting formulas, managing data, and filtering results), Word (creating and editing documents), PowerPoint (creating and editing presentations).

• Driver’s License and ability to travel to multiple sites

• High School Diploma or GED from an accredited institution 

Preferred Qualifications:

• Associate degree from an accredited institution.

• Conflict resolution experience

• Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family

• Experience in an Auditing capacity conducting root cause analysis

• Experience working with confidential information

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $47,403 - $62,400

• All Other Locations (within approved locations): $41,101 - $60,320

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.