Medicaid Customer Service Improvement Manager

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Oversee and guide intricate customer service process enhancements and projects across segments.

• Collaborate with Medicaid Customer Service leaders to enhance customer experience, track key metrics, and identify customer needs.

• Facilitate communication and resolution of issues among internal business partners.

• Advocate for and implement strategic initiatives, providing guidance to customer service personnel on protocols for tracking and reporting outcomes.

• Monitor and enhance First Call Resolution, Customer Experience Index, and Net Promoter Score.

• Analyze routine reports and engage team leads to develop strategies for service enhancement.

• Create methods to evaluate the effectiveness of service strategy initiatives.

• Establish protocols for communicating employee coaching requirements throughout the department.

• Document and enhance customer service procedures.

• Distribute updated processes to customer service representatives, creating and delivering training as needed.

• Guide and manage departmental resource allocation, including ICS ticket resolution and the coordination of claims, customer calls, and correspondence inventories.

• Provide reporting on claims and correspondence while monitoring and improving metric performance.

• Develop and present business cases that support modifications to business practices and processes.

• Respond to extensive group audits and RFPs as required.

• Represent the department in meetings and decision-making processes.

• Supply data support, analysis, tracking, trending, reporting, and recommendations for commercial growth initiatives.

• Identify customer needs and insights, developing targeted action plans accordingly.

• Foster a culture of accountability, collaboration, results orientation, and customer focus.

• Coordinate activities across multiple departments.

• Assist leaders in managing staff performance.

• Provide expertise in claims, correspondence, and customer service to staff members.

• Oversee daily operations and future improvements in customer service activities.

• Identify and coordinate training requirements, offer coaching, and recommend disciplinary actions based on performance metrics.

• Evaluate and suggest recommendations regarding employment decisions.

• Perform other duties as assigned.

⛳️ Requirements

• 7 years of experience in health insurance operations.

• 5 years of supervisory or management experience.

• 3 years of experience in process management.

• High School Diploma or GED in a relevant field of study.

• Extensive knowledge of the health insurance sector.

• Exceptional problem-solving and investigative abilities.

• Excellent relationship-building and communication skills.

• Strong capability to influence others across teams.

• Proficient written and verbal communication skills.

• Intermediate proficiency in using office equipment, including copiers, fax machines, scanners, and telephones.

• Intermediate skills in word processing, spreadsheet, and database software.

• Intermediate PC proficiency.

• Ability to think critically and overcome challenges with a customer-centric approach to achieving results.

• Strong familiarity with contact center metrics, including ASA, Service Level, and First Call Resolution.

• Ability to effectively delegate tasks and take accountability for ensuring work is completed through others.

• Strong interpersonal and active listening skills.

• Ability to establish and maintain collaborative working relationships.

• Capability to manage process improvement projects and mentor individuals effectively.

• Maintain confidentiality and privacy.

• Previous management experience.

• Bachelor's Degree in a relevant field of study (preferred).

• 10 years of experience in health insurance operations (preferred).

• 7 years of supervisory or management experience (preferred).

• 5 years of process management experience (preferred).

• Professional writing skills (preferred).

• Advanced technical and professional mentoring and coaching abilities (preferred).

• Experience managing, leading, and continually developing high-performance teams (preferred).

• Familiarity with Affordable Care Act policies and CMS requirements (preferred).

• Intermediate to advanced knowledge of health insurance enrollment operations systems and transactions (preferred).

• Familiarity with BCBSAZ commercial products and services (preferred).

• Previous contact center management or analytics experience (preferred).

• Ability to optimize resource utilization for cost-effective operations (preferred).

🏝️ Benefits

• Hybrid workforce strategy known as Workability, offering flexibility in work location and hours.

• Opportunity for remote work.

• Access to health insurance products and services.

• Full-time employment.

• Commitment to equal opportunity and nondiscrimination.