Job description

• Provide training to Member Services, Provider Services, and off phone team upon hire as well as ongoing re-training throughout the year. This includes conducting training in classroom settings, one-on-one as well as through developing e-learning content.
• Create and maintain training materials including slide deck, exams, quizzes, role play scenarios, hands on activities, and worksheets. Training topics include new hire onboarding, training to support role changes, system implementations, process updates, and annual refreshers. Maintain and update documents to meet trainee needs as well as reflect updates to CCA policies. This will include researching techniques and material related to customer service and health care delivery systems and incorporating into new and existing trainings.
• Build and maintain procedural workflows for trainees to reference while on the phone to support, including in our interactive knowledge base.
• Maintain reports on staff training performance and progress, as well as training history.
• Monitor Member Services and Provider Services verbal communications with members, providers, representatives, and other callers to ensure compliance with policies, procedures, and regulations as well as to ensure a satisfactory customer service experience.
• Review work complete in CCA systems to ensure appropriate processes were followed and documentation is complete. This includes communication with clinical staff, processing of referrals, reimbursements and disenrollments, and capturing complaints and service requests in a timely and comprehensive manner.
• Provide suggestions for updates to policies and procedures to ensure workflow efficiency and best in class customer service
• Complete required monitoring documentation, such as the call monitoring scorecard, and autofailure emails, to capture successes and areas for improvement.
• Provide feedback and coaching to trainees on their performance, strengths, and areas for improvement.
• Identify areas for innovation and improvement and implement subsequent training and initiatives for the Member Services, Provider Services, and off phone teams based on trends, issues and questions from members, providers, and other callers.
• Lead process improvement projects and writing process improvement plan to help operations meet and exceed quality standards and streamline processes.
• Review and quality check written communications sent to members for accuracy, completeness, and correctness.
• Participate in development of new programs, system implementations, and department initiatives.
• Serve as subject matter expert for a variety of systems, processes, and protocols related to Member Services, Provider Services, and the off-phone teams, providing support throughout the day, troubleshooting, and problem-solving issues raised by staff, leadership, vendors, and other departments.
• Use computerized systems for tracking, information gathering and troubleshooting.
• Access and understand all related educational resource materials in order to respond to questions and concerns accurately and appropriately.
• Assist with advanced data error corrections in database systems when needed.
• Compete other duties as assigned.

Working Conditions: Standard office conditions
Education Required:

• Bachelor's degree or equivalent experience

Experience Required:

• 1-3 years in training, quality, and/or customer service-related field

Knowledge, Skills & Abilities Required:

• Must have 1 or more year of experience providing customer focused service/activities; experience answering multiple calls at one time and managing large amounts of email; experience independently problem-solving by referencing information and policies.
• Must possess exceptional Microsoft Office skills (Word, Excel, Outlook, PowerPoint), and internet research skills
• Must be able to demonstrate productive and independent time management
• Must exhibit strong analytical skills for the understanding, interpretation, and communication of complex data.
• Must possess exceptional oral and written communication skills including the ability to manage difficult behaviors and conflict. Applicants may be asked to provide writing samples during the interview
• Must be able to identify different learning styles and adapt trainings to meet trainees' needs
• Must be able to adapt existing trainings to meet department's specific needs, policies, and procedures
• Must be flexible and comfortable working in an environment that includes continual change for quality improvement
• Must have the ability to: develop a thorough knowledge of benefits, related payment policies, and medical terminology, work independently as well as within a team environment, prioritize work, and manage and track outstanding work and work due in the future.

Language(s) Required:

• English

Language(s) Desired:

• Spanish

Other:

• Be comfortable recording voice and video
• Be comfortable presenting to large and small groups in person or in virtual meetings.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Job Type: Full-time

Schedule:

• Monday to Friday
• Weekend availability

Work setting:

• In-person

Language:

• Spanish (Preferred)

Work Location: Remote

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