Supervisor Call Center Operations (Hybrid - Troy, MI) - Health Alliance Plan

🔍 Troy, Michigan

New
📁
Clinical/Allied Health
📅
256784 Requisition #
📅
11 hours ago Post Date

Primary Objectives

 

To supervise, organize and coordinate the HMO, Medicare Advantage and Federal Government call center operations associated with HAP's Customer Service Department, which includes lobby, written/electronic correspondences, and clerical operations.  To maximize service levels through scheduling, floor management activities, coaching employees and managing performance for service excellence.  To maintain and report on all information related to member inquiries received via the telephone, lobby and written inquiries received throughout the HAP system. 

Duties and Responsibilities:

  • Supervise, develop, coordinate and control all workflow activities in the Customer Service Department (which includes phone monitoring, scheduling staff & adjudicating the phone queue assignment schedule, based on trends to maximize the efficiency of the call center productivity.
  • Ensure compliance with the Centers for Medicare & Medicaid Services (CMS) and other regulatory agency guidelines, such as NCQA.
  • Determine and create training materials, policies, procedures and required telephone scripts related to customer servicing.
  • Maintain quality control within Customer Service based on live monitoring of calls, member feedback via letters, phone, e-mail via HAP’s website, member survey cards, and quality audits performed by the department Quality Auditors.
  • Evaluate employee performance, initiate appropriate coaching and developing and implement disciplinary action within area of responsibility.
  • Develop the Call Center Statistical Analysis Reports on a daily/monthly/annual basis, including developing all associated written policies and procedures.
  • Focus on continuous improvement that will improve the customer experience.
  • Interface with the Client Services Correspondence and Grievance sections to be involved in the integral part of resolution for member complaints/grievances received by HAP.
  • Develop processes/measures that will ensure staff receives continuing education on most current benefits, products, policies, procedures, systems tools, in cooperation with the departmental Training Specialist.
  • Assist and/or handle member complaints received through the President’s Office, Board of Directors, Media, Insurance Bureau, or the Department of Public Health ensuring a focus of customer satisfaction in complaint resolution.
  • Coordinate with Marketing, Membership & Billing, Pharmacy, and Finance Divisions in  the resolutions of service related problems.
  • Work closely with the Compliance Office to ensure service delivery is consistent with regulatory agency requirements (NCQA, DFIS, DOL, HIPAA and CMS).
  • Perform other related duties as assigned.

Requirements:

  • Bachelor’s Degree in Health Care, Business or a related field or a minimum of four (4) years recent and related work experience in customer service may be considered in lieu of the degree.
  • Minimum of two (2) years of experience in health care or insurance environment with focus on Medicare managed care products.
  • Minimum of two (2) years of recent supervisory or team lead experience with evidence of driving customer service improvements.

Abilities

  • Must demonstrate excellent verbal and written communication skills.
  • Demonstrate positive leadership and interpersonal qualities at all times, maintaining the highest degree of tact and diplomacy when working with people.
  • Must demonstrate a high degree of maturity, poise, flexibility and good judgment in responding to inquiries from customers and when coaching employees.
  • Must demonstrate strong analytical and problem-solving skills.
  • Be able to meet multiple deadlines and manage progress of several projects simultaneously.

Knowledge

  • Have a clear understanding of health care delivery systems. 
  • Working knowledge of Medicare Advantage Programs.
  • Knowledge of CMS Compliance regarding customer satisfaction.
  • HMO health care concepts.
  • Obtain and have on-going knowledge of CMS regulations and Medicare managed care concepts.
  • Demonstrate technical understanding of computer systems and be proficient in using a PC.

Overview

HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals,          companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.

 

Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a

$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites

including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and

other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system

now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one

of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the

health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s  

major academic medical centers, receiving between $90-$100 million in annual research funding and

remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical

education and training, the health system has trained nearly 40% of physicians currently practicing

in the state and also provides education and training for other health professionals including nurses,

pharmacists, radiology and respiratory technicians. visit HenryFord.com.

Benefits

Whether it's offering a new medical option, helping you make healthier lifestyle choices or

making the employee enrollment selection experience easier, it's all about choice.  Henry

Ford Health System has a new approach for its employee benefits program - My Choice

Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

dozens of options for all of our employees including compensation, benefits, work/life balance

and learning - options that enhance your career and add value to your personal life.  As an

employee you are provided access to Retirement Programs, an Employee Assistance Program

(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness

and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other

benefits and services. Employee's classified as contingent status are not eligible for benefits

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

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