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American Medical Association

Sr. Training & Quality Specialist (Remote)

Posted an hour ago
$87394 - $115K per year
5-10 years experience
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The role involves designing and delivering training programs while managing quality assurance initiatives for the claims department. It also requires serving as a subject matter expert to improve operational performance and ensure regulatory compliance.

Sr Training & Quality Specialist (Remote)
FL, IL, IN and WI

AMA Insurance (AMAI) offers life, health and disability insurance at affordable and exclusive rates to help doctors achieve a healthy and secure financial future. AMAI is part of the American Medical Association (AMA), a nonprofit, and the nation's largest professional Association of physicians. We are a unifying voice and powerful ally for America's physicians, the patients they care for, and the promise of a healthier nation.  To be part of the AMA is to be part of our Mission to promote the art and science of medicine and the betterment of public health.

At AMA, our mission to improve the health of the nation starts with our people. We foster an inclusive, people-first culture where every employee is empowered to perform at their best. Together, we advance meaningful change in health care and the communities we serve.  

We encourage and support professional development for our employees, and we are dedicated to social responsibility. We invite you to learn more about us and we look forward to getting to know you.  

We have an opportunity for a remote Sr. Training & Quality Specialist on our AMA Insurance team. This role will manage AMA Insurance Claims Department by establishing claims polices and managing all claims related data, processes and procedures for AMA Insurance. Responsible for the timely and accurate processing of claims, ensuring adherence to all carrier requirements and federal/state regulations.. Serves as Agency subject matter expert and primary point of contact for all claims related functions; working closely with internal and external business partners. Responsible for process improvement and the development and utilization of key processing metrics. Manages team of claims processors.

OVERVIEW: 
Designs, develops, delivers, and evaluates training programs and quality assurance initiatives supporting AMA Insurance Agency operations. This role serves as the subject matter expert in employee onboarding, continuous education, business systems, regulatory compliance, and quality improvement, partnering with leaders to identify training needs, develops effective training solutions, and improves operational performance.  

RESPONABILITES: 
Training Development & Delivery - 40%
- Design, develop, maintain, and update training curricula, presentations, job aids, reference guides, procedures, and e-learning materials.
- Deliver instructor-led, virtual, and self-paced training programs for new hires and existing employees.
- Conduct training on new, existing, and enhanced insurance products, systems, compliance requirements, and business processes.
- Develop and facilitate professional development training programs. Coordinate and support onboarding activities for new employees.
- Maintain training records, learning materials, reference guides and documentation.
- Conduct training needs assessments and identify knowledge and performance gaps.
- Measure training effectiveness and modify training content based on learner performance and operational needs.
- Implement and train carrier regulatory and disaster recovery bulletins, identify state-specific customer accommodations or allowances, communicate requirements to operational teams, provide training and guidance, maintain documentation, and ensure compliant implementation of carrier and state disaster relief requirements.
- Conduct training needs assessments and identify knowledge and performance gaps.
- Measure training effectiveness and modify training content based on learner performance and operational needs.
- Implement and train carrier regulatory and disaster recovery bulletins, identify state-specific customer accommodations or allowances, communicate requirements to     operational teams, provide training and guidance, maintain documentation, and ensure compliant implementation of carrier and state disaster relief requirements

Quality Assurance & Coaching - 25%
- Monitor and evaluate customer interactions, including inbound and outbound calls, claim adjudication, enrollment and all Administrative Operations for quality        compliance and service excellence.
- Identify trends, performance gaps, and training opportunities through quality reviews.
- Provide individual coaching, guidance, and skills-based feedback to support employee development and reinforce training objectives.
- Collaborate with managers to support employee development.
- Collaborate with managers to identify learning needs and provide supportive coaching resources that help employees build skills and improve quality outcomes.
- Measure training effectiveness and recommend improvements based on performance outcomes.

Business Consultation, Systems & Compliance Support - 20%
- Serve as an internal consultant to employees and managers by assessing learning needs and recommending appropriate training solutions.
- Develop and deliver training and adoption of Life-Pro and other business systems.
- Support system implementations, enhancements, and process changes through training and documentation.
- Serve as a liaison between operational teams and business stakeholders to translate business requirements into training solutions.
- Ensure training programs support regulatory, compliance, and operational requirements.
- Participate in special projects and strategic initiatives as assigned.
- Assist with administration of professional development and insurance education programs.
- Support change management initiatives related to new products, technologies, and business processes.

Process Improvement & Documentation - 15%
- Participate in continuous improvement initiatives and process optimization efforts.
- Assist with process mapping, workflow analysis and documentation of standard operating procedures.
- Recommend solutions to improve efficiency, accuracy, quality and customer experience.
- Ensure training materials and procedures remain current with system, product, and regulatory changes.  

REQUIREMENTS:
Education
-
Required Bachelor's Degree and or other insurance-related designations preferred.

Years of Experience
- 5+ General insurance operations, training development, quality assurance, or related operational learning functions.

Additional Skills and Experience
 - Knowledge of call center practices and procedures required. Previous experience in a quality assurance role within a call center strongly preferred.
 - Demonstrated experience and ability with curriculum development and learning material design.
 - Knowledge of quality assurance, performance measurement, and employee coaching practices required.
 - Knowledge of insurance products, policy administration, claims processing, underwriting, customer service operations, and applicable regulatory and compliance requirements required.
- Superior verbal communication and presentation skills required. Strong writing skills, especially writing procedures.
- Excellent interpersonal skills. Demonstrated ability to monitor, analyze, evaluate, and coach all Administrative Operations team members effectively. Must be able to    interact and consult with others at all levels.
- Experience participating in continuous improvement initiatives preferred.
- Strong problem-solving, analytical and decision-making skills required.
- Proficient with Microsoft software suite (Word, Power Point, Outlook and Excel) and database software.
- Must be able to manage multiple projects and changing priorities.

This role is an exempt position, and the salary range for this position is $87,394 - $115,797. This is the lowest to highest salary we believe we would pay for this role at the time of this posting. An employee’s pay within the salary range will be determined by a variety of factors including but not limited to business consideration and geographical location, as well as candidate qualifications, such as skills, education, and experience. Employees are also eligible to participate in an incentive plan. To learn more about the American Medical Association’s benefits offerings, please click here.

We are an equal opportunity employer, committed to diversity in our workforce.  All qualified applicants will receive consideration for employment.  As an EOE/AA employer, the American Medical Association will not discriminate in its employment practices due to an applicant’s race, color, religion, sex, age, national origin, sexual orientation, gender identity and veteran or disability status.

THE AMA IS COMMITTED TO IMPROVING THE HEALTH OF THE NATION

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