• Quality Evaluator - Crisis Line

    Elevance HealthNewton, MA 02458

    Job #2695395866

  • Location: Must live in state of Massachusetts

    Job Description Summary:

    Responsible to monitor and evaluate clinical and non-clinical contact between program staff and participants, assessing adherence to protocols and appropriate clinical interaction. Evaluates calls for these major areas: safety, clinical effectiveness, productivity and customer service.

    How you will make an impact:

    • Provides written and/or verbal feedback to program staff to assist with performance improvement and staff development.

    • Develops reporting and overall performance trend identification.

    • Serves as the subject matter expert in the areas of clinical and non-clinical policies and procedures, use of the HMC software and call processes.

    • Ensures each associate meets standard performance criteria and ensures associates are moving program participants toward desired levels of engagement or enrollment, program retention and positive clinical outcomes (i.e. improved health).

    • Analyzes individual and overall trends based on monitoring results and providing recommendations to operations management or learning and Development.

    • Provides quality review process training.

    • Provide training for new employees and assist them with taking calls. Update training materials as needed.

    Minimum Requirements:

    • Requires BS/BA in nursing, social work, respiratory therapy or related clinical field and minimum of 3 years of experience in managed care which includes experience in clinical staff development and education, quality; or any combination of education and experience, which would provide an equivalent background.

    • Current unrestricted license in applicable state(s) for designated field required.

    • Clinically relevant certification and a background in quality or performance improvement preferred.

    Preferred Qualifications:

    • Master's degree

    • Licensed mental health clinician; LPC, LCSW, LCMHC, LMFT

    • Call center experience or crisis line experience

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