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Serves as a liaison between Account Management and internal business partners in executing on strategic initiatives. Facilitates a wide range of complex operational activities. Perform on site implementation of new LOBs, deployment of new processes and conduct post implementation review. Advocate for vendor account management organization during various business owner meetings to ensure vendor processes are represented. Leads cross functional groups in setting the direction for future processes and infrastructure changes based on post-implementation reviews, etc.
Collects and documents business processes from internal teams to Apply analysis and independent judgment to internal business processes and the implementation of processes at vendor sites.
Gathers information and input from multiple sources to make decisions regarding the tools and processes needed for the vendor teams to execute on the strategic initiatives implemented by the Account Relations Managers (ARM)
Identifies how complex vendor tasks and special functions are aligned with internal business functions for accurate and compliant vendor processes.
Leads the implementation of new processes at vendor locations by working with Account Management team on implementations, changes to business practices and revamp of current strategic initiatives.
Chairs cross functional meetings between vendors, ARMS and internal business partners to assist in mitigating barriers to successful implementation
Acts as an empowered liaison between account management and internal business partners such as Operations Support Specialists (OSS), Quality Assurance (QA) in executing on strategic initiatives.
Communicates and reports project status via written and verbal reports to Account Managers, Vendors, and internal business partners.
Facilitates action log meetings with ARMs and OSS and coordinates meetings with business owners.
Develops processes for account management to achieve corporate deliverables, i.e. implementations, cost reductions, CMS and State Agency compliance requirements, new process requirements, etc.
Makes independent decision to ensure processes, tools and system access vendors provide compliant day to day operations that bring quality and value to the total enterprise.
Manages project volumes and tasks to meet critical deadlines.
Represents Account Management team in various work groups/committees as assigned.
Drives ongoing process improvement to deliver increasing vendor quality, compliance, and efficiency in all vendor related processes.
Drives the implementation of best practices for improved performance on CAHPS surveys and Customer Experience.
Performs other duties as assigned.
Required A Bachelor's Degree in Business, Finance or related field
Required Other 4 years experience handling escalated call center issues may substitute for degree
Required 4 years of experience in Handling service issues in a call center environment
Required 1 year of experience in vendor management
Preferred 2 years of experience in overall managed care
Preferred Other Medicare/Medicaid health plan experience
Intermediate Demonstrated interpersonal/verbal communication skills
Intermediate Demonstrated written communication skills
Intermediate Ability to influence internal and external constituents
Advanced Ability to work in a fast paced environment with changing priorities
Advanced Ability to effectively present information and respond to questions from peers and management
Advanced Ability to work independently
Advanced Ability to communicate and make recommendations to upper management
Intermediate Other Solid understanding of managed care, vendor provider agreements and the delegation process
Intermediate Other Proven background in call center operations to manage, implement and optimize services by vendors within customer service environment
Intermediate Other Ability to handle responsibilities that are complex with results that may have long-range implications
Intermediate Other Ability to remain calm under pressure
Intermediate Other Demonstrated aptitude and experience for managing processes across functional teams
Licenses and Certifications: A license in one of the following is required:
Required Intermediate Microsoft Excel
Required Intermediate Microsoft Outlook
Required Intermediate Microsoft PowerPoint
Required Intermediate Microsoft Word
Required Intermediate Healthcare Management Systems (Generic)