Escalation Lead

Scope and Purpose of Position

The Escalation Lead has accountability for handling sensitive concerns, most requiring immediate attention, from a variety of sources for the Provider Relations Team.

Essential Functions
• Responsible to support Provider Relations Team with daily challenges
• Provide feedback and coaching as needed with demonstrated proficiency in Conflict Resolution and Mediation Skills along with quality training as needed in regards to improvements in handling calls
• Follow-up with challenges from external providers, groups, and internal partners.
• Responsible for team metrics to ensure timeliness of resolutions, source data for identifying trends etc.
• Determine and provide for the educational needs of the team associates, coordinating with Education and Quality Assurance
• Record all activity in the appropriate data base(s) and ensure the quality of records maintained
• Develop measurement reports and implement new procedures/processes
• Meet and exceed team key performance indicators and provide data so trending of root cause can be done
• Guide Line as assigned; telephone back-up as needed
• Work with various teams (projects) as needed
• Adhere to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)
• Process credit card orders related to pre-purchase services
• Screen and filter call recording systems for credit cardholder data
• Collaborate on Continuous Improvement Initiatives
• Participate in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals
• This is in addition to the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements

Education & Experience
• Preferred Bachelor's degree in related field or equivalent combination of experience and education
• Provider Service and Member Service Functional Experience preferred
• Computer proficiency including ability to work within Word and develop and work within Excel

Competencies
• Excellent written and oral communication skills
• Demonstrated problem solving skills
• Professional written and verbal communication and interpersonal skills
• Excellent organizational skills including follow-through

HIPAA & Security Requirements

All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company's Privacy & Security Training Program

We take pride in our recruiting process and follow a merit-based employee recruitment practice with extensive screening steps. We will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, age, sex (including pregnancy), sexual orientation, gender identity or expression (including transgender status), national origin, ancestry, status as a protected veteran or disabled veteran, physical or mental disability or history of disability, genetic information, marital status, or any and all other categories protected by under applicable Federal, state or local law.

This policy extends to all associates and to all aspects of the employment relationship. Any associate who violates this policy will be subject to disciplinary action up to and including termination