Performance Improvement Specialist

4 weeks ago

Houston, United States Harris Health System Full time

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

- Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
- Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
- Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
- Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

**Skills / Requirements**:
JOB SUMMARY:
**The Performance Improvement Specialist **will create a Customer Experience Culture by providing daily skill development and coaching of Customer Service Center Representatives to promote positive communication, service excellence and encourage teamwork in a Customer Service Center Environment. They will be responsible for coaching and developing a team of Customer Service Center Agents to exceed the performance metrics and deliver excellent customer service. In addition, they identify coaching opportunities from quality assurance monitoring for inbound and/or outbound contacts of the Customer Service Center Representatives. The Performance Improvement Specialist will ensure that accurate information is provided professionally, courteously, and consistently while providing quality and efficient customer service to Members. This includes but is not limited to, assisting with motivating, recognizing, and rewarding coaching, providing input for counseling, training, and problem solving. Maintain confidentiality of sensitive employee, customer, and company data without exception.

JOB SPECIFICATIONS AND CORE COMPETENCIES
Essential Functions
70% Responsible for coaching and developing team members in all areas of performance including, but not limited to metrics and behaviors related to the customer experience.
20% Provides support for new hires during nesting phase (immediately after training)
10% Sets and monitors performance goals and objectives
Marginal Functions
Other Similar and/or related duties as assigned per the business needs.
Contribution to Goals and Values

Reports to Position Title: Service Quality Supervisor
Employees Supervised Titles: N/A
- MINIMUM QUALIFICATIONS:

- Education/Specialized Training/Licensure:
- High School diploma or GED equivalent

Work Experience (Years and Area):
- 5 years relevant work experience of which: Two years of experience with health care / plan.
- Preferred knowledge of Contact Center operations.

Management Experience (Years and Area): N/A
- Software Proficiencies: Microsoft Office (Word, Excel, Outlook)
- Other:
- Strong analytical, organizational, prioritization and time management skills.
- Ability to work efficiently, pay strict attention to detail and deliver high quality results in a deadline driven environment, while effectively managing associated stress.
- COMPETENCIES
- Organizational Core Competencies:

- All employees are responsible for understanding and demonstrating Community Health Choice core competencies:
- Customer Focus, Sustainability, Reliability and Dependability, Employee Empowerment, Honesty & Integrity, Teamwork, Employee Empowerment, Analytical Thinking, Attention to Detail, Responding Sensitively, Coaching, Exceptional Verbal, Writing /Composing
- INTERPERSONAL SKILLS- Excellent interpersonal, verbal, written, and listening communication skills with a high level of comfort in recommending and implementing solutions.
- Demonstrates the ability to retain and motivate employees.

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