Supervisor, Call Center Provider Inquiry - Health Alliance Plan
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Supervise, develop, coordinate and control all workflow activities in the Provider Inquiry Department (which includes phone monitoring, scheduling staff & adjudicating the phone queue assignment schedule, based on trends to maximize the efficiency of the call center productivity).
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Determine training, policies, procedures and benefit needs related to customer servicing.
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Maintain quality control within Provider Inquiry based on Provide inquiry--- feedback via letters, phone, e-mail via HAP’s website, provider survey cards, and quality audits performed by the department Quality Auditors.
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Evaluate employee performance, initiate appropriate coaching and developing and implement disciplinary action within area of responsibility.
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Develop the Call Center Statistical Analysis Reports on a daily/monthly/annual basis, including developing all associated written policies and procedures.
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Monitor the quality and quantity of the communication between the Client Service Specialists and customers received by telephone and/or in person.
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Focus on continuous improvement on customer service and the development of staff in a customer oriented way.
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Interface with the Customer Services Correspondence and Grievance sections to be involved in the integral part of resolution for member complaints/grievances received by HAP.
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Develop processes/measures that will ensure staff receives continuing education on most current benefits, products, policies, procedures, systems tools, in cooperation with the departmental Training Coordinator.
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Assist and/or handle provider complaints received through the President’s Office, Board of Directors, Media, Insurance Bureau, or the Department of Public Health ensuring a focus of customer satisfaction in complaint resolution.
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Coordinate with internal support departments, i.e., Marketing, Membership & Billing, Claims and Finance Divisions, in the resolutions of enrollment related problems.
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Perform other related duties as assigned.
Education & Experience Required
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Bachelor’s degree in Health Care, Business or related field
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Minimum of three (3) years of experience in a health care or insurance environment
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Minimum of three (3) years of customer service experience in a call center environment and knowledge in claims processing and HMO, PPO and/or Medicare managed products
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Demonstrated experience in driving service improvements
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Must demonstrate excellent verbal and written communication skills
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Must be able to maintain the highest degree of tact and diplomacy
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Must demonstrate a very high degree of maturity, poise, flexibility and good judgment in responding to inquiries from customers with varying attitudes
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Must demonstrate strong analytical and problem solving skills
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Must demonstrate leadership skills that promote teamwork and staff engagement
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Must demonstrate the ability to analyze report data and forecast results for performance improvements.
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Demonstrate a clear understanding of health care delivery systems
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Demonstrate understanding of HMO/AHL health care concepts
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Demonstrate human relations management skills
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Demonstrate technical understanding of database oriented computer systems, i.e. FACETS, PEGA
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Demonstrate proficient use of Microsoft Office software applications, i.e., Word, Excel, Power Point
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 24,600 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by President and CEO Wright Lassiter III. To learn more, visit henryford.com
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Â Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. Â My Choice Rewards is a program as diverse as the people it serves. Â There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. Â As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.