Supervisor, Provider Services Call Center / Job Req 839130628

PRINCIPAL RESPONSIBILITIES:

Hybrid: Full Time must live in one of 6 states: CA, AZ, NV, TX, WA, OR; remote and on site in Alameda County. Available for Full-Time Work Schedule 8:00am – 5pm Pacific Time, Monday-Friday. Hybrid positions work a minimum of up to_2_ days per week in Alameda Alliance for Health’s office, located at _Alameda CA, and a minimum of three days per week remotely.

Under general guidance from the Manager, Provider Services Call Center, the Provider Services Call Center Supervisor is responsible for developing and implementing work flow systems and processes to operate all day to day functions of the Provider Call Center. The Provider Services Supervisor is responsible for ensuring provider concerns are processed in a timely and accurate manner by communicating and enforcing department goals and objectives within a total quality management approach and compliance with all applicable state and federal regulations

Principal responsibilities include:

• Supervises the daily operations of Provider Services Call Center staff to ensure appropriate usage of resources to facilitate the Call Center process.
• Using critical thinking and problem-solving skills, quickly resolve issues and identify resources to ensure a positive member experience and complete satisfaction.
• Hires, trains and develops a Provider Services Call Center team to support call center operations, including but not limited to eligibility verifications, explanation of claim payments, PCP assignment, referral information, addressing provider complaints, and ensure timely responses to service requests.
• Identifies the training needs including assisting in the development of programs, training materials, job aids, orientation checklists, and competency checklists necessary to meet the educational and training needs of the call center staff.
• Meet performance goals established for the position in the areas of efficiency, call quality, provider satisfaction, first call resolution, production, compliance, punctuality, and attendance.
• Monitors real-time information on phone system, reviews incoming call queue statistics and Provider Relations Representative activities. Coaches’ behavior and/or adjust skill assignments to improve customer service response time.
• Monitors, audits documentation, and scores call for Provider Relations Representative monthly as required by department standards
• Educates staff as necessary to ensure consistent performance and adherence to standards.
• Audit staff in accordance with established auditing processes, works with Provider Relations Representatives to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management.
• Monitors all workflows and recommends improvements for efficient operational procedures and employee performance.
• Assist with revisions to Policy and Procedures and work process development.
• Assures that provider questions are answered fully. This includes interaction and work collaboration with all other departments for resolution.
• Completes other duties and special projects as assigned.

ESSENTIAL FUNCTIONS OF THE JOB:

• Uses good customer service skills and respects others. Communicates well and supports team functions.
• Supervising, auditing, monitoring, and training of staff.
• Act as a resource to staff in daily coaching and problem-solving
• Ensure timely communication with Manager on all/any issues having potential risk and or impact on operations.
• Identify trends, patterns, and opportunities for improvement.
• Adapts to recurring operational situations using formal and informal channels. Unusual situations are reviewed with a manager.
• Applies business, scientific, or technical principles to routine and moderately complex problems.
• Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
• Measuring and improving customer satisfaction levels.
• Requires adaptability.

PHYSICAL REQUIREMENTS:

• Constant and close visual work at desk or computer.
• Constant sitting and working at desk.
• Constant data entry using keyboard and/or mouse.
• Frequent use of telephone headset.
• Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Frequent walking and standing.

Number of Employees Supervised: 7-10

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• Bachelor’s Degree or equivalent professional experience.
• Familiarity with Medicaid (Medi-Cal) and other publicly funded programs preferred.
• High School Diploma or GED required.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Three- Five years call center experience in a leadership role in health care setting preferred.
• Two to three years healthcare related experience preferred.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Supervises hourly employees.
• Knowledge of organizational health plan functions desired.
• Proficient in use of various computer system software as well as Windows, Microsoft Word, Microsoft Excel and Microsoft PowerPoint.

Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.

SALARY RANGE $95,742.40 – $143,603.20 Annually

The Alliance is an equal opportunity employer and makes all employment decisions on the basis of merit and business necessity. We strive to have the best-qualified person in every job. The Alliance prohibits unlawful discrimination against any employee or applicant for employment based on race, color, religious creed, sex, gender, transgender status, age, sexual orientation, national origin, ethnicity, citizenship, ancestry, religion, marital status, familial status, status as a victim of domestic violence, assault or stalking, military service/veteran status, physical or mental disability, genetic information, medical condition, employees requesting accommodation of a disability or religious belief, political affiliation or activities, or any other status protected by federal, state, or local laws.

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