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.
Job title:
Job Description:
Education:
Bachelor’s Degree in Nursing
Experience:
2 year post-education clinical experience (Premium PA, EHE Coaching, CPAN, PNA, TCM, IPCM, PC, & PCM only)
2 year post-education clinical experience (CHIL)
Mandatory Skills:
With Moderate Competency Level in the ff.:
US Healthcare Delivery System
Philippine Healthcare Delivery System
Communication Skills (Spoken)
Communications Skills (Written)
Customer Service Orientation
Computer Literacy
Job Knowledge
Sense of Urgency
Passion for Excellence
Working in Team/Interpersonal Skills
Work Organization
People Management/Team Orientation
Drive for Results/Execution
Thriving in Change
Expertise/Analytical Skills
Product Knowledge
Problem Solving
Presentation Skills
Facilitation Skills
Coaching
Process Improvement
Performance Management
Discipline Management
Roles & responsibilities:
Shift Management Function:
Performs daily monitoring of Nurses quality & productivity metrics by utilizing reports and database available.
Implements floor management policies in order to ensure adherence to service level agreements between clients.
Ensures that Nurses scheduled for the day are accounted for.
Ensures connectivity and proper functioning of systems/ equipment of the Nurses prior to the shift and reports to workforce, CT group and Operations Manager for the immediate repair/ replacement of defective unit.
Answers questions while Nurses are on-line and provide assistance in cases of technical problems experienced by Nurses in their function.
Ensures that coaching and huddle schedules on a daily basis are carried out.
Ensures Nurses adherence to schedules – shift schedule and off the phone schedules.
Ensures that Team Leader checklist is completed daily and submitted weekly to his/ her respective leader.
Escalates issues to Operations Manager or Shift Manager.
Accomplish monitoring requirements as needed.
Quality & Policies/Procedures Compliance Monitoring Function:
Be able to provide timely and accurate updates to the Nurses thru scheduled coaching time and/ or ad hoc for Hotline behaviors and/or non-compliance errors.
Be able to carry out process related activities within the prescribed turn-around time.
Ensures that non-compliance errors are coached to Nurses within the turn-around time.
Ensures that all monitored calls are reviewed within the turnaround time.
Attends calibrations and alignment meetings with support groups (QA and/ or Training).
Knows and follows existing internal and external processes of the program.
Be able to carry out disciplinary action documents on a timely manner.
Ensures that Nurses adhere to work schedule.
Staff Development/Team Building Function:
Be able to manage and resolve Nurses’ HR related concerns.
Be able to ensure high morale of the team by carrying out team bonding activities.
Be able to coach Nurses and provide feedback on weekly performance as evidenced by a signed coaching log. Complete one-on-one feedback sessions with Nurses, which can include counseling for disciplinary purposes (Ensure high motivation with low disciplinary actions).
Be able to cascade process/ product updates to Nurse on a timely manner.
Be able to do trend/ call handling analysis on Nurse’s calls for coaching and action planning.
Be able to create specific Individual Development Plans for Nurses over a given period of time.
Be able to effectively cascade internal & client-related policies and programs to Nurses on a timely manner.
Be able to meet with team at least once a week to discuss issues and share best practices.
Be able to identify team members who display potential for other positions within the company. Assign tasks or projects to further develop that potential.
Administrative Function:
Generates individual semi-monthly Employee Attendance Records via Global ESS.
Reflects approved changes on schedules.
Be able to conduct yearly performance appraisals.
Be able to investigate and validate violations to the Project Cigna Code of Conduct, recommends and serves corresponding disciplinary action.
Be able to perform special assignments or handle projects as delegated by leaders.
• Be able to submit reports as needed:
Weekly Coaching logs
Weekly Huddle Agenda
Weekly & Monthly Team Performance Reviews
Yearly Performance Appraisal for each Nurse
IDPs for Nurses
Monthly EXCEED Nominees
Others:
Perform tasks assigned by the Shift Manager.
Periodically conducts interviews and screening for agent positions.
General Safety and Security
Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS).
Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.
Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act and URAC
The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned.
Location: