Quality Assurance Call Auditor (Bilingual English/Spanish)

My Senior Health Plan is looking for upbeat, compassionate individuals who possess native level fluency in both English and Spanish, are hardworking, reliable, and committed to doing their best every day! We have been around for over 17 years but still have the family-business feel! There is MUCH opportunity for growth and development.

Essential Responsibilities:The Quality Assurance Call Audior monitors live and recorded calls for Medicare compliance and quality objectives. This role involves analyzing calls for errors, non-compliance, and improvement opportunities, while collaborating with teams to enhance quality. The analyst tracks KPIs, generates reports for management, and recommends process improvements.
The position also includes evaluating agent performance, providing feedback, contributing to calibration sessions, and updating SOPs. The specialist participates in training and process controls to maintain consistent client service quality and supports recruitment, onboarding, and continuous improvement initiatives through effective communication and policy compliance.

Essential Duties:

• Monitor calls for Medicare compliance and quality objectives.
• Analyze calls for errors and non-compliance.
• Collaborate on quality improvement initiatives.
• Review data on enrollments, grievances, appeals, etc.
• Track KPIs and provide reports to management.
• Recommend process and policy improvements.
• Assist with Quality program training.
• Evaluate agent performance and provide feedback.
• Contribute to call calibration sessions.
• Drive client engagement strategies for efficiency.
• Ensure communication addresses client concerns.
• Support process controls, SOPs, and training.
• Identify and implement process improvements.
• Ensure compliance with service quality policies.
• Report team performance and maintain logs.
• Participate in quality control meetings.
• Assist with recruiting and onboarding.

• Bilingual in English and Spanish required.
• 2 years of experience in managed care, Medicare, Medicaid, or healthcare preferred.
• Associate Degree preferred; relevant experience may substitute.
• Proficient in contact management systems (Salesforce), Microsoft applications, call center phone systems, and monitoring software (Gong).
• Knowledge of federal regulations and industry standards.
• Strong data analysis and problem-solving skills.
• Excellent communication and documentation skills.
• Detail-oriented with focus on data integrity.
• Strong oral communication and presentation skills; effective listener and responder in meetings.
• Clear and informative written communication; proficient in editing and interpreting written materials.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must occasionally lift and/or move up to 25 pounds.

We offer:

• Competitive base pay, based on experience, and bonuses
• Health insurance including Dental, Life, and Vision – Employer pays 70%!
• 401k Match and Profit-sharing
• Paid Sick Time & Vacation Time
• Paid Holidays
• A positive work environment
• Schedule is Monday-Friday 10 am-6:30 pm CST

My Senior Health Plan is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, religious creed, gender, sexual orientation, gender identity, gender expression, transgender, pregnancy, marital status, national origin, ancestry, citizenship status, age, disability, protected Veteran Status, genetics or any other characteristic protected by applicable federal, state, or local law.

*All offers of employment are contingent upon successfully passing a pre-employment drug test and background check. My Senior Health Plan* participates in E-Verify.*