Customer Service Director
This position will be responsible for the timely telephone access of eligible individuals to the customer programs and triage of all calls including information inquiries, services requests, crisis calls, grievances and appeals issues. The Member Services Administrator will collaborate in the planning, development, and implementation of member communication and education programs, services and materials; will ensure member services staff stay abreast to the evolving system of care for accurate, timely, and respective access to care. Investigate and resolve concerns in the CMC; and interact with other department personnel for smooth communication flow to members, families, providers, system stakeholders and anyone who calls the member services line
- Manage and communicate performance standards and measures to the CMC and administrative support service staff to ensure compliance with policies, procedures and customer requirements. Measure performance and productivity against the standards. Ensure the call center is meeting telephone access and quality standards for Magellan and customer program performance requirements including all calls answered by a live voice within 30 sec and an abandonment rate of less than 3%. Maximize utilization of tools and resources (i.e. ACD, satisfaction surveys, reporting tools, IEX, etc.).
- Plan and design management reports, to include call and quality management reports on call performance and support services data. Analyze data to include identification of trends/ patterns and prepare findings and recommendations. Implement recommendations as required. Articulate goals and action plans to key staff
- Recruit, hire, coordinate training, counsel, evaluate performance, and recommend raises and promotions. Promote the highest level of morale, continued development, and service oriented professionals; focused on high quality, culturally appropriate, recovery oriented respectful interactions with all plan members. Develop professional development plans for staff when appropriate, terminate employees. Ensure ongoing and annual performance assessment process is conducted in a meaningful and timely manner, incorporating individual development planning as appropriate, utilizing performance management tools to quantify and document performance coaching
- Plan, develop, implement and monitor customer specific policies and procedures. Interpret and implement corporate policies, procedures and performance standards as they impact on the department. Plan and conduct internal audits to ensure compliance and uniformity, where appropriate
- Manage the complaint and grievance process including the review, response development by appropriate management staff and reporting on all complaints and grievances. Respond to department-specific verbal and written complaints and grievances as required
- Manage the department’s customer/support services quality improvement programs to ensure member satisfaction. In collaboration with customer and Magellan’s Quality Management department, develop survey instrument and data collection devices as per program performance targets; manage the conducting of survey, data collection and analysis, preparation of findings and recommendations; and coordination of reporting to the customer, CMC leadership and other Magellan corporate team members. Attend public forums and community partnership meetings where opportunities for enhanced learning or collaboration are presented
- For ongoing and future plans develop, implement member communication materials as required: Coordinate, plan, and develop CMC member, manuals, and brochures. etc.; Provide advice and comment on proposed program language for program materials such as benefit booklets, certificates, etc.; Coordinate with the Customer Project Manager and CMC leadership for the development, review and distribution of materials to members; Coordinate with Corporate Communications in developing member communications in other languages (non-English) when appropriate
- In collaboration with the Magellan Behavioral Health Training and Quality Management Departments and Customer/Support Services Department, plan, develop, and coordinate training programs, products, benefits and business computer systems for new department staff
Field of Study:
Health services administration, business administration or related field
A minimum of 5 years of management service.
Significant experience and expertise in the management of a Member services department and grievance resolution
An equivalent combination of experience and education is acceptable.
Microsoft Office systems:
Word, Excel, Access and PowerPoint.
Thorough knowledge and understanding of management principles, practice, methods and techniques.
Excellent verbal and written communication and public speaking skills.
Experience in planning, developing, implementing or managing a customer service call center department.
Experience in planning, developing and implementing communication and education programs and materials.
Experience in planning, developing and implementing new business accounts, programs, products or services
Master’s degree, MBA.
Health care or health insurance setting preferred. Member or Provider focus in a health care or health insurance setting preferred.
Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.
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