Responsible and accountable for ensuring that staff are knowledgeable in conjunction with collaborating and updating the department trainer for identifying gaps, refresher training and/or communicating any changes related to these lines of business to include monitoring call center quality outcomes/needs to ensure all regulatory and/or contractually requirements are met. Ensures that all forms of member inquiries, correspondence, complaints, Initial Concern Complaints, and appeals are acknowledged, investigated, resolved, and responded in accordance with Community First Health Plans (Community First) policies, as well as abide by any accredited, organizations, federal and state regulatory entities.