Description: The position is responsible to promote growth and retention of groups in the region by leading cross functional teams and collaborate with operational leads; ensuring smooth and successful end-to-end small group onboarding to Kaiser Permanente, as well as continued management and servicing of employers, broker and general agents for the duration of the contract period. Responsible for delivering quality, consumer experience by managing the client service representative's daily work, monitoring the phone lines and queues to ensure all CSU metrics are met and maintained.
- Manages a team of client support specialists. Provides oversight to meet the Service Level Agreements (SLA's) and established work stream metrics and all defined controls. Provides guidance to staff on analyzing & reporting trends and/or systematic issues as they become apparent, defining root cause and closure on each issue. Reviews work stream metrics provided by staff to ensure accuracy and inclusion of necessary data for reporting. Manage all escalated inquiries with staff members. Manage CSU work calendar and assignments of phone, written and other work for each staff member. Monitors the ACD Phone Lines. Ensures timely and accurate set up of new, small groups. Works on HR processes and recruitment to select, develop, and deploy staff in the most effective manner to meet assigned objectives. Creates team strategy by distributing assignments to staff and checking status of work to ensure completion in a timely manner. Responsible for career pathing, performance management, compensation decisions, rewarding and recognizing employees, and providing on-going, regular performance feedback.
- Works in collaboration with internal partners on internal and/or external audits to ensure compliance.
- Leads cross functional teams in collaboration with the operational leads accountable for elements of the onboarding process inclusive of sales and underwriting.
- Responsible to execute on process improvement solutions designed by the CSU Director.
- Manages or participates in department projects as assigned
- Leads efforts for all group contracts and filings as defined for small group.
- Provides internal guidance and recommendations in policy formulation around service issue areas.
- Performs other duties as assigned.
- Minimum seven (7) years of experience in a health care, health insurance, or sales and marketing environment.
- Minimum four (4) years of direct managerial/supervisory experience required.
- Minimum two (2) years of experience working directly with customers by phone, email and/or in person providing information and resolving issues. Education
- Bachelor's degree required, OR four (4) years of experience in in a directly related field.
- High School Diploma or General Education Development (GED) required. License, Certification, Registration
- Background experience in brokerage/consultant, insurance carrier, TPA, or benefits administration.
- Knowledge of health plan information system technologies including but not limited to: TMS, DIAMOND, MACESS, EpicCare, Salesforce.com, Lotus Notes.
- Ability to analyze processes, identify and implement process improvements, and manage targeted implementations.
- Demonstrated understanding of current / future trends and changes in healthcare/health insurance laws/regulations.
- Demonstrated understanding of competitor's strengths, weaknesses and strategies.
- Ability to analyze quantitative and qualitative data.
- Demonstrated ability to deliver recommendations and presentations to management.
- Ability to communicate effectively and courteously with customers.
- Ability to apply judgment and make autonomous decisions to quickly resolve issues on behalf of client.
- Demonstrated expertise in dealing with difficult situations.
- Demonstrated strong organizational skills, problem solving, interpersonal skills, independence and initiative.
- Effective written and verbal communication skills.
- Proficiency in computer and analytic skills.
- Strong knowledge and experience in using multiple client databases & systems.
- Experience in customer service, enrollment, billing, claims processing, sales, account management or health plan administration in healthcare or health insurance industry preferred.
Job Number: 629566