Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Operation Support
Job title:
Associate - Process Improvement
Job Description:
Duties and Responsibilities below are applicable for both in-office-based and telework based employees:
- Understand Clients Business Strategy and managed care direction.
- Uphold the Client and Sagility Core Values at all times
- Utilize and be familiar with current system functions, applications and enhancements.
- Maintain a high level of professionalism towards peers and customers at all times
- Maintaining the highest level of integrity with the information used and divulged in calls or correspondence.
- Perform tasks in an efficient and effective manner with regard to the delivery of service requirements required by the client, project or company
Process Improvement
- Responsible for monitoring in an objective fashion of all customer contact points (Web, voice, e-mail, white mail) based on set quality norms and guidelines.
- Responsible for reporting all behavior that does not conform to the quality standards set by the company and the account management.
- Provides quantifiable data to all quality judgments that are made.
- Conducts Calibration Sessions with the client and with Operations.
- Conducts product specific coaching sessions with the agents regarding trends and quality.
- Handles incoming calls and/or escalated calls and meets telephone productivity standards on a pre – determined scheduled or when business needs dictate
- Note all situations that arise that were not covered in training or in previous updates. Works with the immediate supervisor to ensure that all other teams, the Quality Assurance Group, and the Training Team are informed so repeat questions do not arise.
- Inform the immediate supervisor when the processes are not working effectively.
- The Process Improvement Analyst must achieve and maintain Key Result Areas.
- Perform tasks assigned by the immediate supervisor
Telework Functions:
- Will continue to conduct quality monitoring for their teams. Frequency and sample size of these audits will remain the same.
- Regular tasks must be scheduled and practiced even remotely and should be well coordinated with the supervisors.
- Teleworkers are expected to meet the same performance requirements as their in-office-based colleagues.
- Should be available during scheduled work hours and ensures they understand their manager's expectations for accessibility and response time when they are working off-site.
- Teleworkers are to meet deadlines and ensure achievement of set targets.
- Teleworkers should promptly respond to calls, e-mails, and instant messages.
- Teleworkers ensure background noises and distractions are kept to a minimum.
- Teleworkers have to be available for contact and communication during the periods in which home- based work is carried out.
- Teleworkers complete periodic reviews with process managers to know their progress and provide any support or performance interventions
- Teleworkers are to comply and be familiar with all teleworking and in-office policies and procedures set forth by the client, the company and the program.
- Teleworkers have adhere to Attendance and Work Hours policies set forth by the client and company.
- Teleworkers must perform work during scheduled work hours only.
- Teleworkers need to account for and report time spent the same way they would at the regular worksite, or according to the terms of the company
- Compliance to work hours must be adhered. Holiday/Leave shall be as per current/regular work hour policy. Extra login must be as per policy/statutory requirement.
- Use the company attendance system and ensure that they are approved before the given timeline every month which shall be used to compute the attendance for payroll processing
- Teleworkers are to ensure that responsibility to care for children or other family or household members or engaging in any other non-work-related interests will not compete with the employee’s work requirements during the designated work hours.
- In the event a teleworker has a change of address for their home worksite, they should notify the designated supervisor in writing at least 7 days prior to the change of address.
- Teleworkers are to report incidences to immediate supervisor and/or the proper authority for immediate resolution
- Teleworkers should report back to office for work when advised by Supervisor. This can be advised based on business needs, Continuous disruption to work at home, performance challenges, Customer complaints and failing compliance audit.
General Safety and Security Responsibilities
- In-office-based and teleworkers Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS).
- In-office-based and teleworkers ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.
- In-office-based and teleworkers reports Information Security related incidents without any delay to the right authority.
- In-office-based and teleworkers remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Gramm Leach Bliley Act or 1999, Centers for Medicare & Medicaid Services (CMS) and Standards of PCI DSS.
- In-office-based and teleworkers are to strictly comply to the Clean Room Policy set by the Client and the Company. This includes but not limited to the following:
- All portable devices are prohibited from entering the clean room environment. This includes, but is not limited to, mobile devices (i.e. phones, tablets, laptops, etc.), printers, USB storage devices and thumb drives, electronic media recording devices or image/screen capture devices.
- For Teleworkers: Exceptions to this requirement (i.e. utilizing personal laptop or cell phone for connection) are granted on limited basis with protocols in place to track and monitor the use of the portable devices.
- For Teleworkers: A cell phone may be used to access a mobile hotspot for connectivity purposes
- For Teleworkers: A cell phone may be used to communicate with a Team Leader or Support Technician
- Copy/Paste and print screen functionality is not allowed
- Users are not permitted to use paper, pen, pencil and printed material in the clean room
- For Teleworkers: Where connectivity is not directly through client's network, all access is achieved through virtual machines or application virtualization (i.e. Citrix or VM Ware)
- Token hardwares will be safeguarded from theft, damage, loss or misuse.
General Safety and Security
- Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS).
- Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.
Competency requirements below are applicable for both in-office-based and telework based employees
With Basic Competency Level in ff:
- Conflict Management
- Discipline Management
- Fiscal Management
- Planning, Organizing, Controlling
With Moderate Competency Level in ff:
- Conflict Management
- Presentation Skills
With Excellent Competency Level in ff:
- Product Knowledge
- Expertise/ Analytical Skills
- Drive for Results/ Execution Communication Skill (Spoken)
- Communication Skill (Written)
- Customer Service Orientation
- Computer Literacy
- Job Knowledge
- Sense of Urgency
- Passion for Excellence
- Working in Teams/ Interpersonal Skills
- Work Organization
- Thriving in Change
- Problem Solving
- Facilitation Skills
- Coaching
- Performance Management
- Business Acumen
- Change Management
- Process Improvement
- Able to establish, implement and continuously improve the quality information security policies assigned to him / her.
- Able to establish structure and procedures to protect classified information.
- Able to report information security related incidents without any delay to the right authority.
Example: All information-related incidents, losses, weaknesses and software/hardware malfunctions, breaches of confidentiality.
- Actively participates during training, orientation and awareness programs pertaining to QISMS.
Other Requirements:
Reports to:
Process Improvement Team Lead
Education and/or Experience:
College Degree (any field)
Certificates, Licenses, Registrations:
QPEP Q100 Certified
- Office-Based Work Environment: The work environment consists of a professional office workplace.
- Telework environment: The work environment should be incompliance with the Clean Room Policy set forth by the Client. Teleworkers must agree to comply with all client's policies and procedures regarding the safekeeping of confidential information. This includes but not limited to the following:
- Their workspace must be isolated from the rest of their home and used exclusively for client business.
- They must make sure that other people in the home cannot see confidential client information at any time.
- They must ensure that household noises cannot be heard as they conduct client business by telephone.
- The phone call conversations must not be heard by others in the house.
- Teleworker’s computer must be password protected and if they leave the workspace, they should lock their screen or shut down their computer. If company documents or equipment is accessible to others in the household when they are not working, they must be secured in locked file cabinets if possible.
Home Inspection for Teleworkers: Teleworkers must agree to allow their managers and/or the program’s Compliance Team to inspect the workspace in their home. This will allow them to work together to ensure the workspace is safe, private, and secure.
Physical demands: The work may sometimes require work during weekends or holidays
Other skills required: Attentive to details, creative in presenting data, fast learner, must have strong and analytical skills and ability to communicate with the client directly. Exceptional communication skills, customer service, problem solving and perfect service characteristics.
Location:
Quezon City, Bridgetowne ZetaPhilippines
What We Do
Sagility is a U.S.-based, tech-enabled healthcare business process management company that supports payers, providers, and their partners to deliver best-in-class operations, enhance the member and provider experience, improve the quality of care and promote health equity all while delivering cost-effective healthcare financial and clinical outcomes.
Sagility Technologies uses a holistic consulting approach to identify the root causes of healthcare payer and provider pain points, analyze the issues, and provide a complete solution that encompasses people, process, and technology platform improvements. Equipped with a strategic solutions mindset, our core focus is on what most benefits the client. Combining healthcare operations and technology experience with advanced UI, UX, and analytics expertise, we develop and deploy customized solutions for our client’s business. Additionally, with our extensive global resources and facilities, we provide the best service/price ratio for any service outsourcing needs.