Department: Operations - Claims
Reports to: Claims Manager
Location: 5301 West Idlewild Avenue Tampa, FL 33634Position provides direct management of non exempt associates and/or assists in activities for the business function (or multiple functions) within Operations, internal and/or external people management, root cause analysis, Trending, and process improvement all can be key aspects of this position. Assignments are broad in nature.
- Manages and monitors key performance metrics and implements improvement plans either to the individual or at an aggregate level.
- Handles all direct employee personnel issues and processes (where applicable), including performance management, appraisal processes, development planning, and career pathing.
- Supervises non exempt direct reports assigning workload, monitoring quality and associate coaching.
- Serves as liaison between departments when it becomes necessary due to member or workflow issues.
- Develops, recommends, and implements process improvements to improve efficiencies and services provided.
- Performs root cause and trending analysis on data error reports from operation systems and business units.
- Updates and creates resources on Well Care link applicable to the call center, such as timely announcements, step actions, reference call tools, FAQs etc.
- Ensures WellCare link is update to with the appropriate materials.
- Trains associates on new processes and refresher training.
- Facilitate and participate in meetings with other departments and line of business as needed.
- Act in a liaison capacity for the Mgr./Sr Mgr. representing operations with other areas and business units.
- Responsible for reviewing, updating, and creating training materials for business.
- Ensures all business processes are compliant with state and federal guidelines
- Demonstrates desired behaviors by exceeding others expectations and leads by example
- Completes gap analysis on training for the business.
- Other duties as assigned.
- Required A High School or GED or equivalent
- Preferred A Bachelor's Degree in a related field
- Required 4 years of experience in a related field based on operational area, i.e., customer service, claims, call center, or a high transactional environment,accounts receivable application, etc.
- Required Other Experience supervising or leading others
- Intermediate demonstrated analytical skills
- Intermediate demonstrated written communication skills
- Intermediate demonstrated interpersonal/verbal communication skills
- Intermediate ability to communicate and make recommendations to upper management
- Intermediate other In-Depth knowledge of Health Insurance
- Intermediate other Strong understanding of managed care and its place in the health care industry
- Intermediate other Understanding of interdependencies on other business units such as Health Services, Provider Relations, Sales, Vendors, Claims
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft Outlook
- Required Intermediate Microsoft Excel