Job Description
JOB DESCRIPTION Job Summary
Leads and supervises team responsible for provision of support center customer service excellence to meet the needs of Molina members and providers. Ensures issues and needs are addressed fairly and effectively, and in alignment with Molina values. Demonstrates accountability for delivery of product and service information, identifies opportunities to improve the member and provider experience, and supports continuous quality improvement initiatives related to member/provider engagement and retention.
Essential Job Duties
• Provides leadership and oversight for the member and provider support center; ensures exemplary service is delivered according to Molina goals/objectives/policies/procedures and regulatory requirements, and demonstrates accountability for performance and financial outcomes.
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Addresses more complex member inquiries, questions and concerns in all related areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.
• Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public.
• Achieves individual performance goals as it relates to call center objectives.
• Demonstrates personal responsibility and accountability and leads by example through individual performance.
• Ensures compliance with contractual and regulatory requirements.
• Recommends and implements programs to support member and provider needs.
• Supports projects and special initiatives as appropriate.
• Sets a positive example for others and builds the Molina culture by modeling the Molina mission, vision and values in daily actions.
• Hires, trains, develops and manages team; demonstrates accountability for team performance and achievement of department-specific goals.
• Models dynamic leadership for support center representatives; develops team to focus on delivering great health care/customer service to underserved populations.
Required Qualifications
• At least 5 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, including 3 years of call center experience, or equivalent combination of relevant education and experience.
• Strong customer service skills.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Ability to work cross-functionally across a highly matrixed organization.
• Strong verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.
Preferred Qualifications
• Management/leadership experience.
• Systems training/experience for the following : Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Managed care/health care experience.
• Broker/health insurance license.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package.
