PURPOSE OF THE JOBProvides oversight and guidance for complex customer service process improvement and segment wide projects. Works with the Medicaid l Customer Service leaders to improve the customer's experience, monitors and targets improvement on key metrics, and identifies key customer needs. Facilitate information exchange and issue resolutions between internal business partners.
REQUIRED QUALIFICATIONSRequired Work Experience- 7 years of experience in health insurance operations
- 5 years of supervisory or management experience
- 3 years of process management experience
Required Education- High School Diploma or GED in general field of study
Required LicensesRequired CertificationsPREFERRED QUALIFICATIONSPreferred Work Experience- 10 years of experience in health insurance operations
- 7 years of supervisory or management experience
- 5 years of process management experience
Preferred Education- Bachelor's Degree in general field of study
Preferred LicensesPreferred CertificationsESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES- Support leadership with championing and implementing strategic initiatives and providing clear direction to customer service staff on success and protocols for tracking and reporting results.
- Monitor activities supporting efforts to improve and maintain success in First Call Resolution, Customer Experience Index, and Net Promoter score. These activities include routine report analytics, engaging team lead(s) in developing tactics for implementing service enhancements, developing methods to measure efficacy of service strategy tactics, and establishing protocols for communicating employee-coaching needs across the department.
- Work with the Customer Service management teams to document and improve processes. Ensure that new and/or improved processes are sent to customer service representatives in a timely and effective manner. Create and provide training as applicable.
- Support Customer Service management and provide guidance and oversight of department resource allocation to support corporate and departmental goals and objectives. This includes accountability for ensuring ICS ticket resolution, as well as accountability for coordinating with team leads and resource planning support to execute strategies for effectively managing claims, customer calls, and correspondence inventories.
- Provide claims and/or correspondence reporting while monitoring and improving metric results.
- Develop and communicate business cases to support recommendations for change to current business practices and processes.
- Respond to large group audits and RFPs as needed.
- Represent the department in meetings and decision-making processes as it relates to the specific area of responsibility.
- Demonstrate a high degree of professional presence.
- Make appropriate decisions based on information at hand with the ability to focus on the big picture while looking for opportunities for improvement.
- Think outside the box and objectively and professionally challenges the status quo that engages others in constructive dialogue to achieve results. Build and foster good working relationships with internal customers and peers.
- Work collaboratively with partners across the organization to provide data support, analysis, tracking, trending, reporting, and recommendations to drive the decision-making and prioritization of commercial growth initiatives.
- Identify areas of customer need and insight. Prioritize and develop actions plans for targeted solutions.
- Advance the segment culture towards one of accountability, collaboration, results-orientation, and most importantly customer centricity.
- Coordinate activities between multiple departments to achieve the desired results.
- Supports leaders in performance management of staff
- Provide in depth Claims, Correspondence, and Customer Service knowledge to staff in order to strengthen and refine the knowledge within the team.
- Maintain effective working relationships to ensure teamwork in achieving corporate goals.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Manage the day-to-day and future customer service improvement activities with leaders engaged in customer service operations.
- Identifies and coordinates training needs, coaching and assists leaders by recommending disciplinary actions based on individual and team performance trends.
- Evaluate and make recommendations regarding employment decisions.
- Perform all other duties as assigned.
REQUIRED COMPETENCIESRequired Job Skills- Extensive knowledge of the health insurance industry
- Excellent problem-solving and investigative skills
- Excellent relationship building and communication skills
- Strong skills in influencing others across teams
- Strong written and verbal communication
- Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
- Intermediate skill in word processing, spreadsheet and database software
- Intermediate PC proficiency
Required Professional Competencies- Ability to think critically and rise above challenges with a customer-centric focus toward achieving results
- Strong familiarity with contact center metrics including ASA, Service Level, and First Call Resolution
- Ability to effecitvely delegate and own accountability for ensuring work is being accomplished through others
- Strong interpersonal and active listening skills. Establish and maintain working relationships in a collborative environment
- Ability to manage process improvement projects and mentor people effectively
- Maintain confidentiality and privacy
Required Leadership Experience and Competencies- Prior management experience
- Translate daily work into impact on organization's mission, vision and values
PREFERRED COMPETENCIESPreferred Job Skills- Professional writing skills
- Advanced technical and professional mentoring and coaching skills
Preferred Professional Competencies- Experience with managing, leading and continuously developing high performance teams
- Familiarity with Affordable Care Act policies, CMS requirements
- Intermediate to advanced knowledge of health insurance enrollment operations systems and transactions
- Familiarity with BCBSAZ commercial products and services
Preferred Leadership Experience and Competencies- Prior contact center management or contact center analytics experience
- Ability to optimize the use of resources at all times to ensure cost effective operations.
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Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
