Customer Care Manager

7 days ago

North Kingstown, United States AmWINS Group Full time
PURPOSE:

The Customer Care Manager supervises daily operations and team members while ensuring efficiency, cost-effectiveness, and absolute customer satisfaction in a complex, inbound Customer Care center. Customer Care Manager, Rx will focus on supporting our Medicare Part D and PBM business by providing a complex level of service to Medicare Part D and Commercial PBM members and managing Customer Care Representatives, Rx.

RESPONSIBILITIES:
  • Lead a team of 10-15 direct reports; coach, develop, and motivate team members to ensure that they provide a fantastic customer experience during every interaction with our customers.
  • Oversees and monitors daily workflow to ensure smooth operations, process efficiency, and quality
  • Develops and motivates staff. Provides ongoing coaching to build high-performing, effective teams.
  • Oversees all escalated issues for representatives and ensures appropriate resolution, cascades yearly/monthly goals through the Performance Check-in process.
  • Communicate key messages effectively to ensure the team is well-informed about issues that may impact them or their customers
  • Be a subject matter expert on PBM and Medicare Part D business; explain processes, protocols, benefits, services to members and (sometimes providers)
  • Ability to ensure the call center team members are actively aware and meeting CMS TATs for ASA
  • Ensures call center reps recognize and file grievances as appropriate.
  • Client Performance Guarantees
  • Ensure calls are following HIPAA privacy laws/ guidelines
  • Participates in planning meetings to support departmental and team member growth
  • Reviews and analyzes performance metrics and identifies opportunities to improve processes and service
  • Establishes and maintains program direction/changes and communicates internally or with clients as needed
  • Drive a culture of continuous improvement, innovation, and excellence in service
  • Develop and audit strategies to ensure the delivery of top-notch experience
  • Encourages and supports a culture of positive change, opportunity, and excellence
QUALIFICATIONS:
  • At least 5+ years of Customer Service / Customer Care experience in insurance or financial services is preferred, with a minimum of 2 years in a leadership position
  • At least three years of experience with Five9 and Virtual Observer software
  • One to three years of experience in the PBM or health plan pharmacy space
  • Candidate should have working knowledge of Part D plans and be able to study and correctly interpret CMS Guidance
  • Ability to work in a fast-paced environment and report results to leadership
  • Superior communications skills - both written and verbal
  • Must be able to build a highly engaged, committed, and empowered workforce
  • Strong understanding of the Customer Care environment and growing the team while keeping key performance metrics
  • Ability to interpret various data sets, on-call team performance, and develop actionable improvement plans
  • Experienced with IVRs, routing rules, and setup of phone experience to match best practices.
  • Understanding the key performance metrics to evaluate team improvement over time
  • Work constructively with others to achieve shared goals.
  • Must have excellent people skills, able to relate to and motivate people of diverse backgrounds
  • Strong leadership and management skills, like working hands-on with the team
  • Critical thinking and strong decision-making skills to resolve any questions or issues for our customers or employees
  • Ability to handle multiple priorities, jumping from training employees to solving client issues to thinking strategically about long-term growth

CERTIFICATES, LICENSES, REGISTRATIONS: Life and Health license

LEADERSHIP COMPETENCIES:

MANAGER

Collaborates

Building partnerships and working collaboratively with others to meet shared objectives.

Manages Conflict

Handling conflict situations effectively, with a minimum of noise.

Courage

Stepping up to address difficult issues, saying what needs to be said.

Decision Quality

Making good and timely decisions that keep the organization moving forward.

Values Differences

Recognizing the value that different perspectives and cultures bring to an organization.

Directs Work

Providing direction, delegating, and removing obstacles to get work done.

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