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Supervisor, Member Services

4 months ago

Rancho Cucamonga, United States Inland Empire Health Plan Full time

Overview:

What you can expect

Find joy in serving others with IEHP We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience

Under the general supervision of the Call Center All Other Channel Manager, the Call Center All Other Channel Supervisor is primarily responsible to lead the day-to-day call center activities and operations as it relates to the Medicare Line of Business and queue. The Call Center All Other Channel Supervisor will work in concert with other departmental supervisors and Team to achieve IEHPs overall service and call center goals. In addition, the Manager will be responsible to monitor the Medicare Grievance and Appeals and all other channel reporting to ensure that training, materials, and operational processes are in place and updated as appropriate. Coordinate an effective way to disseminate information to the Team when changes are made at the state level and/or internally.

Key Responsibilities:

1. Supervise all aspects of day-to-day operations of a Member Service Team whose primary calls are Medicare Line of Business (LOB). Ensure that calls received by Member Services Call Center are answered in a timely, efficient, friendly, and knowledgeable manner.
2. Oversee performance of Member Service Team to ensure training materials, job resources and operational processes are in place and updated as appropriate. Work with internal resources to develop updated job resources and deliver training as needed. Ensure Member Service Representatives (MSRs) are appropriately supervised and provided guidance, training and support related to call taking procedures, departmental goals and expectations.
3. Attend and participate in internal Medicare meetings to stay current on Medicare operational regulations and call center expectations and practices.
4. Stay current on Medicare regulations as it relates to call center operations and ensure call center practices are put in place to meet expected service goals. In addition, will assist all department Team Members to understand pertinent Medicare activities and program changes as needed provide the best overall service to IEHP Members.
5. Develop, review, analyze and interpret department and individual performance reports to ensure that the Team is continually performing at optimum levels. Work with the department management and the quality and training Team to improve operational processes.
6. Develops and implements operational practices and interfaces with internal IEHP departments to ensure Members care is delivered in a service-oriented manner and according to IEHP benefits, policies, and procedures. Continually identifies opportunities for process improvement, service opportunities and Member retention.
7. Supervise daily call center operations including proper and efficient utilization of staffing to achieve organizational service and quality goals. Lead and support supervisory goals regarding Team performance objectives including coaching and motivating MSRs with data-based decision making.
8. Supervise Medicare MSRs and assist with department operations including, hiring, training, performance objectives, Team Member evaluations and disciplinary actions to ensure compliance with IEHP policies and procedures.
9. Through demonstrated individual performance, the Medicare Supervisor shall promote the highest standards of ethical and professional conduct to lead Team Members by example.
10. Analyze reports and data from all departmental activities and review for trend or results that require intervention or re-direction of Department activities or processes.
11. Demonstrate a commitment to LEAN by leading and implementing a process improvement project in the Business Unit(s).
12. Demonstrate a commitment to understand and adhere to the Regulatory requirements as they relate to the business unit(s).
13. Operational IEHP NCQA/HEDIS initiatives. Implement outreach call campaigns. (Member retention, HEDIS initiatives). In addition, responsible for managing, reporting and timely resolution of all case follow-up, web portal inquiries, chat, incoming mail, faxes, and walk-ins.
14. Demonstrate commitment to Team Member engagement by participating in projects/tasks/activities that promote Team Member excitement and enthusiasm for their roles, commitment to the organization, and increased effort in their work Ensure TMs participate in the annual Employee Engagement Survey. Additionally, Supervisor will ensure:
a. Understanding of overall and department/unit specific Employee Engagement Survey results
b. Ability to use the tool kit resources provided
c. Ability to facilitate dialogue during feedback sessions
d. Clear understanding of expectations

Commitment to Quality: The IEHP Team is committed to incorporate IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

  • CalPERS retirement
  • 457(b) option with a contribution match
  • Generous paid time off- vacation, holidays, sick
  • State of the art fitness center on-site
  • Medical Insurance with Dental and Vision
  • Paid life insurance for employees with additional options
  • Short-term, and long-term disability options
  • Pet care insurance
  • Flexible Spending Account Health Care/Childcare
  • Wellness programs that promote a healthy work-life balance
  • Career advancement opportunities and professional development
  • Competitive salary with annual merit increase
  • Team bonus opportunities


Qualifications:

Education & Experience

  • Three (3) or more years of healthcare call center experience working in a health care delivery setting. Experience in an HMO, Managed Care, knowledge with IEHP Dual Choice Product and or Medicare and Medi-Cal business practices.
  • Two (2) years of experience working directly with Medicare/Medi-Cal Members. Prior call center supervision required.
  • Experience working directly with Medicare/Medi-Cal Members preferably in a call center environment.
  • High school diploma or GED required.

Key Qualifications

  • Knowledgeable in IEHP product lines and programs preferred. Knowledgeable in call center supervisory practices.
  • Proficient in microcomputer applications (Microsoft Word, Excel). Excellent written and verbal communication, interpersonal skills. Strong organizational skills and sound decision-making skills required.
  • Ability to establish and maintain effective working relationships with others, ability to supervise and train Team Members. Detailed oriented. Ability to balance multiple projects and meet deadlines.

Start your journey towards a thriving future with IEHP and apply TODAY

Pay Range:
USD $34.41 - USD $44.73 /Hr.