This position is responsible for managing the delivery of member and provider services and management of the call center. This includes planning, developing and implementing member and provider communications and education programs, services and materials. The role will investigate and resolve account concerns and interact with other departments for a smooth flow of communications. This position is also accountable for developing, mentoring, training and retaining staff.
- Manage the care management center (CMC) and support services (if applicable) to ensure compliance with policies, procedures and customer requirements. Measure performance and productivity against the standards. Ensure the call center is meeting telephone access standard for Magellan.
- Plan and design management reports on customer and support services data. Analyze data to include identification of trends/ patterns and prepare findings and recommendations. Implement recommendations as required. Articulate goals and action plans (when in place) to key staff.
- Recruit, hire, coordinate training, counsel, and evaluate performance.
- Develop professional development plans for their staff when appropriate, terminate employees.
- Plan, develop, implement and monitor specific policies and procedures. Interpret and implement corporate policies, procedures and performance standards as they impact on the department. Plan and conduct internal audits to ensure compliance and uniformity, where appropriate.
- Manage the complaint and grievance process including the review, response development by appropriate management staff and reporting to the corporate office on all complaints and grievances. Respond to department-specific verbal and written complaints and grievances as required.
- Manage the department?s customer/support services quality improvement programs to ensure member and provider satisfaction. In collaboration with corporate office management, develop survey instrument and data collection devices; manage the conducting of survey, data collection and analysis, preparation of findings and recommendations; and coordination of reporting to the RSC and corporate offices.
- P articipate in the planning, development and implementation of new accounts, programs, products and services, initiate and develop short and long range plans for department, and participate in the development of corporate and strategic plans.
- For ongoing and future programs, products and services, plan, develop and implement member and provider communication materials as required.
- Plan and prepare introductory letters/correspondence to members, providers and employers; Coordinate with business clients for the development, review and distribution of materials to members and providers.
- In collaboration with the Training and Customer/Support Services Department, plan and develop training programs on specific programs, products, benefits and business client computer systems for new department staff.
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
Minimum of 5+ years of direct management service in a call center environment., -Thorough knowledge and understanding of call center management principles, practice, methods and techniques, including performance metrics. -Excellent verbal and written communication skills. -Knowledge of provider relations or network development. -Experience in planning, developing and implementing communication and education programs/materials.-Experience in planning, developing and implementing new business accounts, programs, products or services in healthcare industry