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Medicare and MLTC Customer Services Supervisor

Company: MetroPlus Health Plan
Location: New York
Posted on: August 7, 2022

Job Description:

Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.Position OverviewThe Medicare and MLTC Customer Services supervisor is responsible for providing oversight for customer service staff and maintaining a high quality, efficient customer service team by managing the tasks and responsibilities of all Customer Services staff. The supervisor is responsible for the supervision and coordination of the activities of staff members engaged in handling service inquiries of providers, members, and their benefit plans, received via incoming telephone calls, mail, etc. Participates and leads various department projects. The supervisor is also responsible for creating and promoting a team environment for Medicare and MLTC Customer Services Representatives that support and facilitate the delivery of superior customer service to both internal and external clients. This position contributes to the goals and objectives of the Call Center through planning and representing the team's needs and interests.Job Description

  • Leads a team of approximately 15 Customer Service Representatives (CSRs) in delivering high quality service to MetroPlus Customers.
  • Creates and promotes a team environment for Medicare Customer Service Representatives that supports and facilitates the delivery of superior customer service to both internal and external clients.
  • Stays current with Medicare and Medicaid regulations applying such to day-to-day operations of the department to maintain corporate compliance and CMS regulations.
  • Provides (at minimum) monthly feedback to all direct reports through quality and coaching sessions utilizing quality scorecards to measure performance and documenting within employee timelines.
  • Handles escalated call from customers often involving complex and challenging situations, and resolves them to the customer s satisfaction, while adhering to all company and regulatory policies and procedures.
  • Serves as a liaison between other departments for resolution of member/provider related issues.
  • Understands Work Force Management duties and monitoring of call queues, and applicable reports and Call Center Performance metrics as it relates to adherence, ACW, AHT.
  • Works collaboratively with the Workforce Management Team to ensure appropriate staffing needs, coverage maintenance, CSR schedule adherence and average handle time monitoring.
  • Collaborates in setting productivity standards for staff and participates in quality assurance programs for business operations.
  • Recognizes and recommends operational improvements.
  • Monitors and provides feedback on performance of staff members according to established monitoring standards.
  • Responds to internal and external inquiries and complaints, notifies appropriate party of specific issues, and ensures timely resolution.
  • Identifies, analyzes, and resolves technical problems arising through the use of a variety of management tools.
  • Collaborates with the Manager in planning for business operations, coordinates communications, and workflow procedures.
  • Attends meetings, participates in committees as assigned. Advises management of new initiative status as needed.
  • Ensures effective staff training, interviews candidates for employment, evaluates staff performance and recommends hiring, promotions, and terminations, as appropriate.
  • Conduct weekly huddles with team providing employees with knowledge refreshers, organizational updates and using opportunity to highlight high performers.
  • Ensure CSRs complete all compliance required assignments on time.
  • Maintain knowledge of all policies, procedures, and regulations as it relates to MetroPlus and Health Management systems.
  • All other duties as assigned.Minimum Qualifications
    • Bachelor s Degree in Business Administration or Health Services or 5 years of related experience.
    • Medicare/Medicaid experience.
    • Minimum three years of supervisory experience in a fast paced and high stress environment. Preferably in a call center environment or managed care environment.
    • Minimum three years demonstrated experience in employee development and performance management.
    • Experience leading and managing a remote workforce highly desired but not required.
    • Intermediate proficiency in MS suite of products (excel, outlook, PowerPoint, etc.).Professional Competencies
      • Integrity and Trust
      • Customer Focus
      • Functional/Technical skills
      • Written/Oral Communication Associated topics: customer care manager, customer service manager, customer service team manager, expertise, lead, leadership, operations, operations manager, product support, senior

Keywords: MetroPlus Health Plan, New York , Medicare and MLTC Customer Services Supervisor, Other , New York, New York

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