QA Analyst (Health Services)

About Us

The 32BJ Benefit Funds (“the Funds”) administers Health, Pension, Retirement Savings, Training, and Legal Services benefits to over 185,000 SEIU 32BJ members. Our mission is to make significant contributions to the lives of our members by providing high-quality benefits and services. We uphold five core values: Flexibility, Initiative, Respect, Sustainability, and Teamwork (FIRST). The Funds oversees and manages $11 billion in assets from various sources, including property owners who pay into the funds on behalf of their employees.

The 32BJ Health Fund is a multiemployer labor management fund providing health benefits to SEIU Local 32BJ members and their dependents. It is self-insured and serves approximately 200,000 people across multiple states and Washington, DC. The Fund offers comprehensive coverage for medical, hospital, prescription drug, vision, dental, short- and long-term disability, and life insurance. To deliver cost-effective, high-quality care, the Fund uses value-based plan design and innovative purchasing strategies, including the 32BJ Maternity Program and Centers of Excellence for Joint Replacement and Weight Loss (Bariatric) Surgery.

About the Role

The 32BJ Health Fund seeks a Quality Assurance (QA) Analyst to provide technical assessments of member calls and notations in corporate systems made by Health Services staff, including Patient Advocates (PA) and Patient Coordinators. Reporting to the Supervisor, Health Services Quality Assurance, the QA Analyst will perform concurrent monitoring and assessment of phone calls, quality control on notes, and produce reports on audits, identifying trends and making recommendations for improvement. The role also involves identifying workflow deficiencies, conducting telephonic member surveys, and supporting special projects.

Responsibilities

• Perform concurrent monitoring, assessment, and scoring of phone calls between 32BJ members and Patient Advocates (PAs) to evaluate accuracy, professionalism, timeliness, telephone presentation skills, and responsiveness.
• Perform quality control on the timeliness and accuracy of PA documentation in Microsoft Dynamics, vendor systems, and internal systems to ensure compliance with corporate standards.
• Analyze quality review results, performance metrics, and operational data to identify trends, recurring issues, root causes, and opportunities for process improvement.
• Identify deficiencies, investigate errors, develop recommendations, and produce reports on findings for management review.
• Identify training needs for PAs and advise management on individual performance improvements.
• Provide feedback to management on trends and prevalent processing errors that may indicate system problems.
• Identify exceptional PA performance and recommend employee recognition when appropriate.
• Assist in the development, maintenance, and enhancement of quality standards, audit tools, scorecards, procedures, and performance measurement methodologies.
• Conduct telephonic surveys on Health Fund programs in a timely manner.
• Support departmental audits, compliance reviews, and special projects focused on improving operational efficiency, quality outcomes, and member experience.
• Perform other duties as requested by management.

Requirements

• 3+ years of experience in call center operations, healthcare operations, health services, or a related field.
• Expert knowledge of internal corporate systems (Dynamics, Cisco, V3, etc.), the benefits offered by the Fund, and Health Services standard operating procedures.
• Prior experience conducting call audits, quality reviews, and performance evaluations preferred.
• Strong experience in member call and note-taking requirements.
• Demonstrates attention to detail, quality, and consistency.
• Outstanding written, oral communication, and interpersonal skills.
• Ability to maintain the highest level of confidentiality and credibility when assessing customer care protocols.
• Embraces the mission, purpose, and vision of the 32BJ Health Fund.

Qualifications

• Able to work both independently and collaboratively within a team-oriented environment while maintaining independent judgment.
• Superior ability to provide constructive support and promote positive morale.
• Strong organizational and time management skills with the ability to manage multiple priorities.
• Ability to remain objective, fair, and consistent when conducting quality reviews and evaluations.
• Demonstrates a continuous and proactive mindset.
• Associate degree or equivalent work experience in the healthcare industry preferred.
• Bilingual: Speak, read, write, and understand English and Spanish required.

Physical Demands

• Under 1/3 of the time: Standing, walking, climbing or balancing, stooping, kneeling, crouching, or crawling.
• Over 2/3 of the time: Talking or hearing.
• 100% of the time: Using hands.

Work Environment

• 1/3 to 2/3 of the time: Work near moving or mechanical parts, exposure to radiation, moderate noise.