Oversees the day-to-day activities of the team to achieve quality and service driven objectives. Monitors productivity and quality of outbound calls, inbound calls and documentation according to policies and procedures. Manages the team's E-time and attendance. Handles escalated issues as needed.
Reports to: Director, Utilization Management
Department: Care management
Location: Tampa, FL
Additional Responsibilities: Candidate Education:
- Supervises non-clinical support staff and department workflows to achieve successful quality outcomes and benefit maximization towards members' care.
- Supervises processes and procedures to ensure compliance with contractual, regulatory (Federal/State) and accreditation entities.
- Provides leadership and support to front-line staff.
- Monitors and tracks production and quality driven work and outcomes of team.
- Monitors associates' performance, productivity and quality through standard reports.
- Conducts one-on-one coaching and provides associates feedback routinely and as needed.
- Provides counseling/corrective action procedures when required.
- Maintains documentation of performance including attendance and disciplinary actions.
- Provides significant input into associates' performance evaluations and hiring/terminations.
- Manages the E-time process - including training and education.
- Conducts training for new associates and re-training based on changing policy and procedure
- Prepares and completes projects, reports and assignments as needed to meet departmental goals and initiatives.
- Attends company meetings in absence of manager.
- Makes process improvement recommendations to management.
- Act as primary contact for escalated calls and/or escalated issues or that require additional research and/or special handling.
- Investigates issues of an unusual nature and proposes solutions in a clear and concise manner.
- Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.
- Performs special projects as necessary
- Required An Associate's Degree in a related field
- Required 4 years of experience in a health care customer service or call center environment
- Preferred 1 year experience in leading/supervising others
Licenses and Certifications:
- Intermediate Demonstrated problem solving skills
- Intermediate Ability to work within tight timeframes and meet strict deadlines
- Intermediate Ability to work independently
- Intermediate Ability to work in a fast paced environment with changing priorities
- Intermediate Demonstrated interpersonal/verbal communication skills
- Intermediate Demonstrated written communication skills
- Intermediate Ability to lead/manage others
- Intermediate Other Demonstrate effective critical thinking and decision making skills
A license in one of the following is required:
- Required Intermediate Microsoft Word Proficient in Microsoft Outlook applications, including Word,Excel, Power Point and Outlook
- Required Intermediate Microsoft Outlook Ability to use proprietary health care management system
- Required Intermediate Microsoft Excel
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Healthcare Management Systems (Generic)