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Position 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
Licenses and Certifications: A license in one of the following is required: