Job description

Duties:

• To manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options.
• To evaluate staff development, customer service results and operational processes in order to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies.
• To collaborate with counterparts within the Health Plan to initiate and support organization wide performance improvement initiatives.
• To manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options.
• To evaluate staff development, customer service results and operational processes in order to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies.
• To collaborate with counterparts within the Health Plan to initiate and support organization wide performance improvement initiatives.
• Coordinate efforts of department to develop and implement policies and procedures for provision of improved or new services
• Perform 24 hour on call duties as required
• Completes timely performance appraisals for direct reports
• Assures that new staff attends hospital orientation within 30 days of employment
• Reports financial performance on a monthly basis
• Develops and modifies job descriptions as necessary
• Prepares and submits annual capital and operating budgets
• Conducts appropriate investigations and follows-up on individual and patient complaints
• Submits performance planning documents, ongoing planning materials, action plan and department goals
• Must have call center operations experience in an healthcare setting with a minimum of 5 years of people leadership experience
• Required for completely satisfactory performance in this job is industry knowledge specific to the market served by the
• Health Plan -- managed health care.
• Must have understanding of a Call Center business environment, tools and terminology; knowledge of claim processing and claim systems, provider contracting, health care benefits, and how Health Maintenance Organizations work.
• Preferable to have knowledge of Texas Department of Insurance requirements for the handling of Member complaints and appeals.
• Required for completely satisfactory performance in this job is the ability to demonstrate and act on an understanding of the collective concerns of internal and external customers; demonstrate an understanding of how the parts of a problem are related and interact in order to create an outcome; motivate employees through personal example; display effective coaching and interpersonal skills; display effective problem-solving skills, including the ability to resolve conflicts, troubleshoot issues and respond quickly to any situation.
• Must be customer focused, including displaying behaviors such as follow-through and courtesy.
• Must have the ability to communicate effectively and be adaptable.

ProjectHealth

Job Types: Full-time, Contract

Salary: $40.00 - $45.00 per hour

Schedule:

• 8 hour shift
• Day shift
• Every weekend
• Monday to Friday
• Weekend availability

Experience:

• Call center: 5 years (Required)
• Customer service: 5 years (Required)
• Supervising: 5 years (Required)
• Team management: 5 years (Required)
• Call center management: 5 years (Required)
• healthcare: 5 years (Required)
• Hospital: 5 years (Required)

Work Location: Remote

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