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SUPERVISOR MEMBER SERVICES - HOAG CLINIC ENGAGEMENT SERVICE

Department:  Business Services
Status:  Full Time
Shift:  1st

<span style="font-family:"Times New Roman",serif">The Supervisor of Member Services will be responsible for the leadership and successful management of the Hoag Clinic Contact Center; overseeing inbound and outbound communications to members, providers, and network partners. The Supervisor will work closely with Hoag Clinic leaders to deliver a concierge experience that is attentive to the members’ needs and provides guidance and assistance navigating through the healthcare delivery system. This position involves the provision of accurate customer support for patients and physician offices regarding member services related inquiries (scheduling, claims, provider inquiries, eligibility and enrollment, etc.) The Supervisor is responsible for developing and managing employees and processes, creates and utilizes analytics to track and assess employee performance. Ensures the highest level of service and member satisfaction through a variety of customer contact channels that includes but not limited to phone, email, web chat, video, fax, etc. Applies proven human resources management skills in staff selection, development, and evaluation. Creates a strong culture of teamwork and customer service to ensure the quality of daily operations, effective interdepartmental collaborations, and the timely achievement of objectives. Provides staff coaching and ensures professional development in supervisory training and problem resolution. Conducts ongoing evaluation and monitoring of contact center policies, procedures, and systems, to maintain best practices and regulatory compliance. Consults with Information Technology on changes, updates, and improvements to systems. Collaborates with clinical, technical, administrative, and management to develop or improve workflows and coordination of efforts across inter-departments and functions. The supervisor must possess strong communication skills, be organized, reliable and must motivate and encourage contact center employees through positive communication and feedback. This position is responsible for overseeing the recruitment, training, development and retention of contact center staff. The Supervisor maintains a patient-focused approach towards operational excellence while working as an integral part of Hoag Clinic.

 

<span style="font-family:"Times New Roman",serif">Essential Functions

  • <span style="font-family:"Times New Roman",serif">Oversees a team of contact center staff addressing inbound and outbound communications across multiple communication channels (phone/email/chat) with a concierge level of support supporting a range of functions (scheduling, enrollment/eligibility, referrals, provider network inquiries, claims, grievances, provider record changes, provider disputes, etc.)
  • <span style="font-family:"Times New Roman",serif">Handle member and provider escalations from direct reports and other internal stakeholders and develop processes for service recovery.
  • <span style="font-family:"Times New Roman",serif">Serves as liaison with other areas and business units
  • <span style="font-family:"Times New Roman",serif">Researches complicated member issues, and handling complex details related to member eligibility, benefits, authorizations, billing, and regulatory requirements
  • <span style="font-family:"Times New Roman",serif">Sets the team goals, helping define the team culture, coaching and developing team members to aspire to deliver a best-in-class experience
  • <span style="font-family:"Times New Roman",serif">Manage service deployment through key performance indicators, visual management, and quality assurance processes
  • <span style="font-family:"Times New Roman",serif">Partner with Hoag Clinic leaders and Quality department to implement strategies that motivate and enable members to act on HEDIS compliance and acquire timely access to care
  • <span style="font-family:"Times New Roman",serif">Develop working relationships with physician offices and Hoag departmental leaders in the development of a one Hoag experience.
  • <span style="font-family:"Times New Roman",serif">Looks for and presents opportunities to improve and innovate processes, techniques, procedures, or methods.
  • <span style="font-family:"Times New Roman",serif">Complete operations by developing schedules, assigning and monitoring work, gathering resources, implementing productivity standards, resolving operations problems, maintaining reference manuals and implementing new procedures
  • <span style="font-family:"Times New Roman",serif">Partners with IT, Hoag Clinic leaders, and other stakeholders to increase efficiency and drive consumer experience with process automation, sophisticated business intelligence, and self-service tools.
  • <span style="font-family:"Times New Roman",serif">Serve as a role model for Hoag Experience and facilitate strategies that integrate with all aspects of Member Services operations
  • <span style="font-family:"Times New Roman",serif">Responsible for performance and conduct management of staff members. Executes performance appraisals, provides conflict resolution, presents employee commendations, and implements progressive disciplinary actions as needed.
  • <span style="font-family:"Times New Roman",serif">Provide direction, setting clear expectations, coaching and motivating direct reports in daily administration of their duties and fosters environment of continuous improvement
  • <span style="font-family:"Times New Roman",serif">Responsible for the recruitment and retention of qualified supervisors and staff.
  • <span style="font-family:"Times New Roman",serif">Monitors and maintains proper staffing levels. Proactively anticipates staff gaps and applies remediation tactics
  • <span style="font-family:"Times New Roman",serif">Conducts regularly scheduled staff meetings and weekly huddles to communicate issues regarding compliance with established procedures and overall work unit effectiveness.
  • <span style="font-family:"Times New Roman",serif">Contribute to wider company goals and help build and scale operations.
  • <span style="font-family:"Times New Roman",serif">Prepare and present call operation reports to upper management
  • <span style="font-family:"Times New Roman",serif">Attend relevant workshops and review relevant literature to maintain an up-to-date
  • <span style="font-family:"Times New Roman",serif">Identifies problems with the department, analyzes and resolves with appropriate action
  • <span style="font-family:"Times New Roman",serif">Applies the GREAT model of leadership to position responsibilities
  • <span style="font-family:"Times New Roman",serif">Performs other duties as assigned
  • <span style="font-family:"Times New Roman",serif">Perform other duties as assigned.

 

 

<span style="font-family:"Times New Roman",serif">Education, Training and Experience

 

<span style="font-family:"Times New Roman",serif">Required:

  • <span style="font-family:"Times New Roman",serif">At least five years of people management experience in a call center environment

<span style="font-family:"Times New Roman",serif">•     Associates degree and/or equivalent years of management experience

<span style="font-family:"Times New Roman",serif">•     Knowledge of the healthcare industry and related benefit products and services

<span style="font-family:"Times New Roman",serif">•     Excellent communication and project management skills

 

 

 

  • <span style="font-family:"Times New Roman",serif">Working knowledge of call center and chat team operations and systems to support contact center metrics and performance. (InContact)
  • <span style="font-family:"Times New Roman",serif"> Experience scaling a team and leading teams through change
  • <span style="font-family:"Times New Roman",serif">Experience with Quality Management (HEDIS, IHA AMP, IHA STARs)
  • <span style="font-family:"Times New Roman",serif">Project Management Certification (PMP, CAPM, etc.)
  • <span style="font-family:"Times New Roman",serif">Six Sigma Certification
  • <span style="font-family:"Times New Roman",serif">Medical Profession Certification (Medical Assistant, Medical Billing Specialist, Medical Coding Specialist, Licensed Practical Nurse, etc.)
  • <span style="font-family:"Times New Roman",serif"> Experience with CRM platforms
  • <span style="font-family:"Times New Roman",serif"> Experience with Epic Tapestry
  • <span style="font-family:"Times New Roman",serif"> Experience with Microsoft Suite (Visio, PowerPoint, Project, Excel) and Visualization tools

 

<span style="font-family:"Times New Roman",serif">Preferred: BA/BS

 

 

<span style="font-family:"Times New Roman",serif">Skills or Other Qualifications

 

<span style="font-family:"Times New Roman",serif">Required:

  • <span style="font-family:"Times New Roman",serif">Analytically minded and apt to make data-driven decisions
  • <span style="font-family:"Times New Roman",serif"> Passion for growing and developing teams
  • <span style="font-family:"Times New Roman",serif"> Possess strong empathy skills and a steadfast commitment to providing great customer service
  • <span style="font-family:"Times New Roman",serif"> Excellent organizational skills, including the ability to multi-task, handle several projects
  • <span style="font-family:"Times New Roman",serif"> Superior verbal and written skills, including the ability to communicate effectively with the highest level of tact and diplomacy with all levels of personnel employees.
  • <span style="font-family:"Times New Roman",serif"> Demonstrated success in managing performance and development of others (either directly or indirectly).
  • <span style="font-family:"Times New Roman",serif"> Demonstrated ability to facilitate team meetings and deliver presentations.
  • <span style="font-family:"Times New Roman",serif"> Independent self-starter; work independently within established guidelines and maintains confidentiality.

 

<span style="font-family:"Times New Roman",serif">License and Certifications

 

<span style="font-family:"Times New Roman",serif">Preferred: MA, LVN

 


Nearest Major Market: Orange County
Nearest Secondary Market: Los Angeles

Job Segment: Clinic, Medical, Manager, EMR, Law, Healthcare, Management, Legal

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