Member Provider Services Supervisor

Company: CHS
Location: Clearwater
Posted on: May 3, 2021

Job Description:

Summary: Member Provider Services Supervisor provides leadership and coordinates activities of the Member Provider Services department. Essential Duties and Responsibilities: - Analyzes reports and statistical data to identify training needs; helps develop training programs in coordination with the Continuous Quality Improvement Department (CQI). - Helps develop and implement departmental policies and procedures for all programs - Monitors achievement and maintenance of goals and objectives per state mandates, carrier, reinsurer and program managers requirements and company standards - Monitors quality assurance program results to ensure company objectives are met - Investigates complaints, grievances and appeals and resolves in accordance with documented policy and procedures by program - Communicates with Program Partners regarding MPS related matters - Work closely with call center sales managers - Reviews and keeps up-to-date on applicable program, plan and policy provisions to include creating program specific scripts for Provider Relations Representatives to follow. - Assists Member/Provider Service and Provider Relations Representatives with difficult calls - Monitors and manages Call Tracking System - Maintains Call Center Productivity Indicators - Develop and maintain creative production and quality incentive programs Other Responsibilities: - Adheres to the policies and procedures of Premier Administrative Solutions - Maintains strict confidentiality of client, company and personnel information - Demonstrates a strong commitment to the mission and values of the organization - Adheres to company attendance standards - Performs other duties as assigned Supervisory Responsibilities: Over 10-20 employees. Competencies: - Strong organizational, interpersonal and motivational skills - Excellent written and verbal communication skills - Detail oriented - High level of reasoning and analytical skills - Ability to multi-task and work independently Qualifications: - A minimum of three (3) years previous Supervisory experience in a Call Center Environment - Deep knowledge of inbound and outbound call center experience to include sales of health insurance related products - Prefer a minimum of five (5) years in the Health Insurance industry Education and/or Experience: - A Bachelors Degree in Business or related field is strongly preferred. - Knowledge of medical and dental coding, insurance billing and/or claims Computer Skills: Proficiency using a Windows XP computer platform; Proficient in word processing and spreadsheet software. Environmental Factors/Physical Demands: Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds. ID: 2021-2134 External Company Name: People Premier External Company URL: Street: 13600 ICOT Boulevard Telecommute: No Overview (Text Only): Summary: Member Provider Services Supervisor provides leadership and coordinates activities of the Member Provider Services department. Responsibilities (Text Only): Essential Duties and Responsibilities: - Analyzes reports and statistical data to identify training needs; helps develop training programs in coordination with the Continuous Quality Improvement Department (CQI). - Helps develop and implement departmental policies and procedures for all programs - Monitors achievement and maintenance of goals and objectives per state mandates, carrier, reinsurer and program managers requirements and company standards - Monitors quality assurance program results to ensure company objectives are met - Investigates complaints, grievances and appeals and resolves in accordance with documented policy and procedures by program - Communicates with Program Partners regarding MPS related matters - Work closely with call center sales managers - Reviews and keeps up-to-date on applicable program, plan and policy provisions to include creating program specific scripts for Provider Relations Representatives to follow. - Assists Member/Provider Service and Provider Relations Representatives with difficult calls - Monitors and manages Call Tracking System - Maintains Call Center Productivity Indicators - Develop and maintain creative production and quality incentive programs Other Responsibilities: - Adheres to the policies and procedures of Premier Administrative Solutions - Maintains strict confidentiality of client, company and personnel information - Demonstrates a strong commitment to the mission and values of the organization - Adheres to company attendance standards - Performs other duties as assigned Supervisory Responsibilities: Over 10-20 employees. Qualifications (Text Only): Competencies: - Strong organizational, interpersonal and motivational skills - Excellent written and verbal communication skills - Detail oriented - High level of reasoning and analytical skills - Ability to multi-task and work independently Qualifications: - A minimum of three (3) years previous Supervisory experience in a Call Center Environment - Deep knowledge of inbound and outbound call center experience to include sales of health insurance related products - Prefer a minimum of five (5) years in the Health Insurance industry Education and/or Experience: - A Bachelors Degree in Business or related field is strongly preferred. - Knowledge of medical and dental coding, insurance billing and/or claims Computer Skills: Proficiency using a Windows XP computer platform; Proficient in word processing and spreadsheet software. Environmental Factors/Physical Demands: Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

Keywords: CHS, Clearwater , Member Provider Services Supervisor, Other , Clearwater, Florida