CALL CENTER MONITORING MANAGER – 61364

Executive Service

Call Center Monitoring Manager

Division of TennCare

Member Services – Vendor Operations Group (VOG)

Nashville, TN

Salary: Minimum Monthly Salary $5,591/month TennCare compensation is equitable and will be based on education and experience for a qualified candidate in accordance with Department of Human Resources (DOHR) policy.

Closing Date: 09/23/2024

The Division of TennCare is dedicated to providing our employees with a hybrid work environment. All TennCare positions have a combination of work from home and work in the office, which varies by position, department, and business need. You may review the specific expectations with our hiring team.

This position requires a background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Who we are and what we do:

TennCare is Tennessee’s managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.7 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS). TennCare’s mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and worked collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.

Job Overview:

The Division of TennCare is seeking a Call Center Monitoring Manager in the Vendor Operations Group within Member Services. They will work under immediate supervision of a Contact Center Analyst and other levels of staff who will utilize the TennCare Eligibility Determination System (TEDS), SNOW (Service Now), NICE CXone and other Vendor Supplied Telephony Equipment to audit and process applications and determine eligibility for Institutional Medicaid. The Call Center Monitoring Manager will ensure that staff effectively communicates with vendors, applicants, members, families, facilities, and Authorized Representatives as needed to relay clear information and expectations of the information needed for an accurate eligibility determination. Additionally, the Call Center Monitoring Manager will be responsible for monitoring systemic and service level performance, productivity and process the quality of Vendor and State staff. Finally, the Call Center Monitoring Manager will work collaboratively and proactively with the TennCare Eligibility Director to identify areas of concern and create continuous quality and process improvement plans, develop routine and ad hoc reporting, and lead technology enhancement development through comprehensive data and program analytics.

Key Responsibilities:

• Supervise a team of TennCare Program Coordinators and other levels of staff
• Build and maintain reporting of semi-complex data leveraged to make business decisions in Tableau and Excel.
• Identify areas of risk and opportunities for enhancement within an OmniChannel platform (Amazon AWS, NICE, Five9) and CRM solution.
• Collaborate with Vendors on design and implementation of technical and functional enhancements.
• Validate, test, and track Vendor compliance with Contractual Technical and Functional requirements related to OmniChannel telephony systems (Amazon AWS, NICE, Five9) and CRM requirements.
• Draft step-by-step audit instructions and process guides to be leveraged by State staff and Vendors.
• Provide support and guidance to staff on matters relating to Medicaid rules, regulations, policies and procedures
• Ensure tasks and audits are processed within the designated time-frame by monitoring, assessing, and addressing the team’s overall performance
• Monitor staff production and quality by reviewing team performance reports and performing required case reads
• Provide coaching and guidance to ensure staff are meeting goals set forth by the agency and in compliance with TennCare policy following established business processes
• Identify areas of opportunity and provide effective problem-solving techniques to ensure that the areas of opportunity are resolved in a positive manner
• Utilize Edison to monitor leave balances, approve/deny leave requests and approving payable time
• Utilize the SMART formula to evaluate/rate employee performance throughout the performance review cycle
• Build team morale to ensure staff have a positive and inclusive work environment, which leads to higher job satisfaction, and results in greater team efficiencies and effectiveness
• Conduct weekly team meetings to provide timely information regarding processes, initiatives, directives, and training opportunities, as well as discuss staff ideas for continuous work process improvement
• Provide clear and concise verbal and written communication and guidance to staff in a positive manner

Minimum Qualifications:

• Bachelor’s degree and 3+ years of full-time professional staff administrative experience or related work

OR

• An equivalent combination of education and work experience may be considered.

Desirable qualifications:

• Graduation from an accredited college or university with a bachelor’s degree and/or experience equivalent to five years of professional level experience interpreting policy or procedural provisions for a TennCare, Medicaid, Managed Care, or other related health insurance organization, or supervising professional staff who deal with health insurance.
• 2+ years experience in implementation and/or enhancements of OmniChannel solutions (Amazon AWS, NICE, Five9) including, but not limited to, IVR, call routing, reporting, and dashboards.
• 1+ years experience in implementation and/or enhancements of CRM solutions including customization and leveraging APIs
• 1-3 years of management experience in a call center environment
• 1 Year experience creating and maintaining Tableau Dashboards
• 1 Year experience working in JMP, SOLQ, or similar data software
• 1 year of eligibility experience within TennCare Member Services
• Advanced Excel skills including, but not limited to Graphing, Pivot Tables, and Formulas (logical, mathematical, and statistical)
• Experience mining, cleaning, and analyzing large datasets including numerical and text data in Excel (this one can drop below too- up to biz unit)

Pursuant to the State of Tennessee’s Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State’s policy to provide an environment free of discrimination and harassment of an individual because of that person’s race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran’s status or any other category protected by state and/or federal civil rights laws.

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