Member Svs Quality Audit Specialist - (US-FL-Doral - 33182)

Minimum Education: None
Job Type: Full Time
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Responsibilities and Requirements : One of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience. Role:Quality Audit Specialist Assignment:Member Services Department Location:CarePlus - Doral Office Are you a fit?Do you enjoy providing exceptional customer service? Would you like to interact with CarePlus' customers to help diagnose and resolve their problems and concerns? If so, then read on! Assignment CapsuleIn this highly visible role as a Quality Audit Specialist you will: evaluate data, track data trends, scrutinize information and provide sophisticated solutions to address issues. Analyze errors to determine origin and communicate outcomes and solutions (written or verbally) to Team Leads or Frontline Leaders. Recommend process improvement activities pertaining to system enhancements or procedural changes Create and maintain proactive communication with other departments to ensure a positive ongoing relationshipKey CompetenciesBuild Trust: You honor your word by doing what you say you are going to do. Champions the Customer: You keep closely attuned to the needs and perspectives of customers and use this insight for the benefit of the business. Drives for excellence: You are a continuous learner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition. Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.Role EssentialsBachelor Degree or equivalent experience required Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, and Access Fully bi-lingual in English & Spanish Prior experience in Medicare Advantage Programs - required Excellent grammatical skills Good communications skills in Spanish and English Commitment to preserving confidentialityReporting RelationshipsYou will report to the Member Services Implementation Advisor.

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