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Supervisor Member Relations

Philadelphia, PA, United States

Why Choose Health Partners Plans?Health Partners Plans is an award-winning, not-for-profit health maintenance organization serving more than 280,000 members for more than 30 years. Health Partners Plans has been doing it right and improving health and wellness in communities throughout the Greater Southeastern Pennsylvania region.

Why Choose Jefferson Health Plans?

We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.

While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.

Perks of JHP and why you will love it here:

Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing

Flextime and Work-at-Home Options

Impact on the communities we service

We are seeking a talented and enthusiastic Supervisor Member Relations to join our team!

General Description:

Ensure efficient operation of the Member Relations department through rigorous evaluation of staff performance—review staff members’ application of established quality measures and department service procedures. Report on service and quality trends and assist in identifying department procedures that require updating. Provide support to Management with staff evaluations, meeting attendance, general call center workflow, direction to staff as it relates to Operating Guidelines, and proper documentation of quality and performance issues. Serve as a department resource for Information systems evaluation and upgrades. This role requires mastering and demonstrating skills and concepts within the call center across multiple businesses (enrollment, appeals, and grievances, pharmacy, provider, claims, billing, marketing, etc.).

As the Supervisor Member Relations, your daily duties may include:

Meet monthly key contact center performance goals for customer satisfaction, quality, productivity, and critical performance metrics.

Monitor and evaluate monthly agent performance, including call/email and after-work monitoring (using call recording and quality assurance applications), review productivity and attendance reports, and coach staff members to improve performance.

Conduct formal agent performance reviews, including annual goal-setting/performance development plan, mid-year performance review, and final year-end performance review. Assist agents with career development.

Monitor queue and track inbound calls. Keep agents aware of inbound calls, calls waiting, abandonment rate, etc.

Address challenging customers and issues that require escalation outside of the department.

Report, analyze, and resolve system, customer, and operational issues that impact service quality. Strive to provide all customers with an outstanding customer experience.

Build, establish and maintain open lines of communication with agents, peers, trainers, managers, QA specialists, Marketing, and other company areas to facilitate problem-solving.

Stay informed of all new processes and services.

Support and promote all company and departmental service and quality initiatives.

Interview and hire prospective agents

Assist in administering team attendance records, salary plans, vacation and staffing schedules, and forecasts.

Build and maintain a positive working environment that attracts and retains high-quality staff.

Be visible to agents. Supervisors should walk around periodically to perform live monitoring of agents, compliment agents for on-the-spot performance, and assist agents struggling with calls.

Plan and manage a range of non-phone activities for agents, including workshops, call center cross-training, eLearning courses, knowledge reinforcement, and brainstorming sessions.

Other duties as assigned

Qualifications

Associates degree or equivalent from a 2-year College or University OR 1-2 years of experience and/or training or equivalent combination of education and experience5-7 years progressive managed care experience.

Call center experience in a supervisory/lead role preferred.

Skills, We Value:

Excellent written and verbal communications skills.

Bilingual is a plus, but not necessary.

Ability to work independent of direct supervision, but also must be able to work within a Team.

Proficiency in Departmental Information Systems including DPW, Member Health Information System, and Pharmacy Systems.

Health Partners Plans is a nationally recognized company for its innovations in care. Health Partners Plans is more than your average health care company and can help you achieve your career goals!

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Supervisor Member Relations jobs in Philadelphia, PA, United States

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