Quality Advocate

Minneapolis, Minnesota
Jan 31, 2013
Jan 31, 2013
Employment Status
Full Time

Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.

The Quality Advocate will provide individual customer service representative (CSR) feedback and coaching on call observations. Data collect and provide a comprehensive approach to analyzing and reporting data related to quality monitoring. Assist with the development and implementation of quality call monitoring programs and resources for the Customer Services staff.   Develop, monitor, and maintain the Customer Services policies and procedures related to quality assurance in compliance with all regulatory requirements. Provide feedback on individual performance. Serve as an expert resource to supervisors /managers in the development, implementation, assessment, evaluation and reporting of quality improvement activities for Customer Services. Ensure that overall quality monitoring reporting activities are in compliance with state, federal and regulatory requirements. Provide accurate monthly reporting to the Customer Services Leadership Team. In collaboration with the Supervisors, analyze the results of monthly audits, identify department training needs and assist with training to both new and existing staff. Specific duties and responsibilities include:

  • Provide daily feedback on quality of service to customer service reps through calls, emails or other interaction channel observations.
  • Collaborate with department leaders to design data collection processes, and assist in developing and implementing a method to assess data accuracy and completeness.
  • Provide data analysis to support departmental performance improvement efforts.
  • Collaborate with the Training team to develop, maintain, and audit call center training curriculum and resource materials.
  • Provide model behavior and leadership in support of Customer Services Star Rating and CAHPS goals.
  • Document the data collection process and maintain a resource library.
  • Serve as a resource and coach to designated Customer Services staff.
  • Coordinate with others in the department to ensure departmental monitoring standards are met.
  • Contribute to the QA reporting functions of data entry, analysis, report creation and publication.
  • Collaborate with managers and trainers to identify unit trends, individual training needs and changes to individual audits that may be needed as UCare, CMS or DHS guidelines change.
  • Provide weekly evaluation results to the supervisors and provide feedback to staff with their evaluation results within 48 hours of performing an evaluation on their call(s).
  • Assist in developing and implementing evaluation tools to monitor new staff during training period.
  • Develop training, as appropriate, to educate staff on new or revised monitoring policies and procedures.
  • Collaborate with other UCare departments and committees; participate in the analysis, development, and delivery of monitoring/audit programs for UCare staff.
  • Represent Customer Services functions during audits or reviews with state, federal, or other outside agencies.

High school diploma or equivalent required. College degree in training, business or communication field preferred; experience and proven performance considered in lieu of degree.

Three to four years Customer Service industry experience is required. Managed care experience in Medicare or State programs and three to five years experience in a health insurance or managed care environment is required.


Experience with training, auditing, and quality management program development is desired. Knowledge of CMS, Medicare, DHS rules and regulations and Supervisory, Team Lead, or quality management experience is preferred.


Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers. At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

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