Oversees the day-to-day activities of the team to achieve quality and service driven objectives. Monitors productivity and quality of outbound calls, inbound calls and documentation according to policies and procedures. Manages the team's E-time and attendance. Handles escalated issues as needed.
DEPARTMENT: PHS-FL CMS
REPORTS TO: Manager, Care Coordination
Supervises non-clinical support staff and department workflows to achieve successful quality outcomes and benefit maximization towards members' care.
Supervises processes and procedures to ensure compliance with contractual, regulatory (Federal/State) and accreditation entities.
Provides leadership and support to front-line staff.
Monitors and tracks production and quality driven work and outcomes of team.
Monitors associates' performance, productivity and quality through standard reports.
Conducts one-on-one coaching and provides associates feedback routinely and as needed.
Provides counseling/corrective action procedures when required.
Maintains documentation of performance including attendance and disciplinary actions.
Provides significant input into associates' performance evaluations and hiring/terminations.
Manages the E-time process - including training and education.
Conducts training for new associates and re-training based on changing policy and procedure
Prepares and completes projects, reports and assignments as needed to meet departmental goals and initiatives.
Attends company meetings in absence of manager.
Makes process improvement recommendations to management.
Act as primary contact for escalated calls and/or escalated issues or that require additional research and/or special handling.
Investigates issues of an unusual nature and proposes solutions in a clear and concise manner.
Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.
Performs special projects as necessary
Required an Associate's Degree in a related field
Required 4 years of experience in a health care customer service or call center environment
Preferred 1 year experience in leading/supervising others
Intermediate demonstrated problem solving skills
Intermediate ability to work within tight timeframes and meet strict deadlines
Intermediate ability to work independently
Intermediate ability to work in a fast paced environment with changing priorities
Intermediate demonstrated interpersonal/verbal communication skills
Intermediate demonstrated written communication skills
Intermediate ability to lead/manage others
Intermediate demonstrate effective critical thinking and decision making skills
Required intermediate Microsoft Word
Required intermediate Microsoft Outlook
Ability to use proprietary health care management system
Required intermediate Microsoft Excel
Required intermediate Microsoft PowerPoint
Required intermediate Healthcare Management Systems (Generic)
Bilingual English/Spanish helpful.
About us Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.