The Customer Service Supervisor is responsible for overseeing a team of Customer Service Representatives, as well as: customer service functions, member enrollment, customer helpline performance, member and provider education and outreach and assist in the development and distribution of materials. This position helps to develop goals for and monitors the success of the department. The Customer Service Supervisor is responsible for meeting the department reporting requirements and will also help to deliver and promote the MDwise Core Values and ensure the department is providing exceptional service to MDwise customers.
- Oversee the day-to-day operations of the Customer Service Department.
- Ensure the department meets State contractual performance standards.
- Oversee the caller education process to ensure that members and providers are properly informed on how the programs operate, availability of covered services, benefit limitations, emergency services, PMP enrollment and assignment, specialty provider referrals, self-referral services, preventative and enhanced services and the member and provider inquiry, grievance and appeals process.
- Assist in the development, design and implementation of culturally and linguistically competent policies and procedures, as well as member materials. Member materials include such things as educational brochures, newsletters, healthcare projects, member website, special mailings and other communications.
- Manage the incoming member and provider complaint, grievance and appeals process and work closely with other departments such as Medical Affairs and Quality Improvement to make sure member issues are addressed and resolved in an appropriate and timely manner.
- Organize, delegate, and monitor tasks and projects with the department.
- Manage staff scheduling to ensure maximum coverage of department functions.
- Assist in updating the Customer Service Manual and Knowledge Base as needed.
- Examine data from ACD phone reports to determine needs and potential gaps in order to meet performance standards.
- Field escalated or supervisor-requested calls and coach Customer Service Representatives to handle similar calls in the future.
- Serve as back-up to handle customer service duties should the need arise.
- Keep staff informed on changes in State and MDwise policies.
- Research and assist with problem solving. Act as a resource for Customer Service staff. Identify and suggest areas for improvement.
- Work closely with other Customer Service Supervisors, Managers, and Team Leaders, to coordinate processes and overlapping issues between departments/teams.
- In conjunction with appropriate management staff, assist in the development and implementation of a training program for the Customer Service Department, including ongoing training and skills enhancement practices.
- Interview and hire new Customer Service staff.
- Supervise and monitor Customer Service representatives.
- Track and evaluate Customer Service staff goals and performance, including the 90-day and annual performance reviews. Establish personal improvement plans and goals based on department policies and procedures.
- Use performance measurement tools such as call monitoring, random complaint review, and call coding reports on a regular basis to assist in identifying performance and training issues.
- Maintain appropriate personnel records and confidentiality of such records.
- Organize and conduct department trainings and meetings, as well as one-on-one coaching and training. Provide support to Managers and Customer Service Trainer/Quality Analyst in quarterly department trainings.
- Assist in developing incentive plans for staff to motivate better job performance.
- Act as a liaison between other MDwise departments, business partners, and other program entities.
- Participate in MDwise committees and meetings as necessary.
- Perform other duties as assigned.
Knowledge, Skills, and Abilities:
- Demonstrated excellent interpersonal communication and presentation skills.
- Excellent time-management and organizational skills and the ability to accurately complete all reports on a timely basis.
- Superior conflict resolution and negotiation skills. Ability to handle difficult situations diplomatically.
- Knowledge of diverse populations.
- Knowledge of creative educational tactics for the relevant population.
- Knowledge of community resources.
- Strong leadership skills.
- Excellent analytical and problem solving skills.
- Demonstrated ability to assess department’s work quality and develop / implement process improvements to achieve contractual and oversight compliance.
- Ability to build strong relationships within and outside of MDwise and establish trust and credibility at all levels of the organization.
- Ability to teach and mentor on a one-to-one and group basis.
- Ability to manage a variety of complex issues while working on key projects.
- Strong computer skills. Proficiency and speed working in all Microsoft Office Suite applications.
- Excellent oral and written communication skills; take the initiative to actively communicate information in an appropriate manner.
- Model and support effective team interactions.
- Knowledge of ACD phone systems and reporting functions.
Minimum Qualification, Training, and Experience:
- Bachelor’s degree in business, health, or social service related field preferred, but will consider experience in lieu of degree.
- Experience with the Indiana Health Coverage Programs population strongly preferred.
- Managed care and Medicaid experience desired.
- Supervisory experience required.
- Call center / customer service experience required.
MDwise, Inc - 16 months ago