Reports To: Sr. Manager, Operations
The primary function of this position is to supervise the activities of the Eligibility Research team in order to meet/exceed department standards and turnaround times.
· Supervises and is responsible for all eligibility research staff.
· Coordinates workflow and assignments of subordinate staff.
· Monitors performance and productivity standards, both individually and collectively.
· Monitors staff production, ensuring research is completed within same day for CSMA, 24 hours for Member Services and 48 hours for Claims.
· Assists staff in resolving problem research within the timelines for each type of research as specified.
· Audits staff by reviewing a designated amount of research requests per rep per day.
· Researches eligibility requests that did not meet performance standards and identifies ways to improve the research process.
· Evaluates performance, provides constructive feedback, conducts counseling and training sessions, and supports staff members in the accomplishment of assigned objectives and goals.
· Documents all coaching and counseling sessions with subordinate staff.
· Participates in the hiring and termination processes.
· Trains new staff.
· Prepares and delivers performance appraisals.
· Evaluates staffing and resource needs and makes recommendations to Manager.
· Ensures that the team represents ASH in an ethical, professional, and positive manner.
· Maintains confidentiality of all member and provider data.
· Compiles and reports daily, weekly and monthly status activity and results.
· Prepares employee production reports for Manager.
· Monitors incoming work and current work inventory and is prepared to report results to Manager at any time.
· Produces monthly departmental reports monitoring the team’s progress and needs and outlining any outstanding issues or problems.
· Performs other duties and responsibilities as assigned.
· High School diploma or equivalent.
· Two years experience in Managed Care or related field; one year in a supervisory capacity preferred.
· Computer experience in word processing and spreadsheets required. Knowledge of Microsoft Word, Access and Excel required.
· Strong analytical, problem solving, and written and verbal skills.
· Demonstrated peer leadership.
· Demonstrated training/mentoring ability.
· Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
· Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
· Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
· Ability to effectively organize, prioritize, multi-task and manage time.
· Demonstrated accuracy and productivity in a changing environment with constant interruptions.
· Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
· Ability to exercise strict confidentiality in all matters.
Mobility: Primarily sedentary, able to sit for long periods of time.
Physical Requirements: Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in oral and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.
Environmental Conditions: Usual office setting.
ASH Companies - 12 months ago