Associate- Operations Quality

at  Sagility

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

EDUCATION AND/OR EXPERIENCE:

College Degree (any field)
Certificates, Licenses, Registrations:
QPEP Q100 Certified
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Office-Based Work Environment: The work environment consists of a professional office workplace.
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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’s business.
• They must make sure that other people in the home cannot see confidential Client’s information at any time.
• They must ensure that household noises cannot be heard as they conduct client’s 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.

DUTIES AND RESPONSIBILITIES BELOW ARE APPLICABLE FOR BOTH IN-OFFICE-BASED AND TELEWORK BASED EMPLOYEES:

• Understand Client’s 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

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 theClean 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.