This role is responsible for increasing member satisfaction, retention, and growth by efficiently delivering competitive services to our members through a fully integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes. This role’s duties include:• Maintaining oversight of functions in local service center, including but not limited to customer service, claim, provider services, complaints, grievances, and appeals, implementation, and/or plan sponsor operations• Executing local strategic and operational plan in support of business segment customer service objectives and initiatives• Planning, directing, and implementing procedures that will assure a high level of customer access and satisfaction• Responsibility for the quality and effectiveness of own team and related teams, identifying and resolving technical, operational and team problems• Managing a team of professional employees and/or supervisors.• Oversee the operations in a local service center handling a customer service function, which may include claims, member services • Develop, monitor, and review performance reports and service performance trends for each account against the plan and recommends specific actions or remedies as necessary• Develop, train, evaluate, and coach staff to provide cost effective claim and customer service while ensuring that quality standards are met• Assess individual and team performance on a regular basis and provide candid and timely developmental feedback; monitors training plans and ensure training needs are met• Establish a clear vision aligned with company values; set specific challenging and achievable objectives and action plans; motivate others to balance customer needs and business success; challenge self and others to look to the future to create quality products, services, and solutions. • Attract, select, and retain high caliber, diverse talent able to successfully achieve or exceed business goals; build a cohesive team that works well together. • Create and maintain tools, job aids, and training materials to help employees in their efforts to resolve issues and improve their relationship with customers • Collect, analyze, and report on operations information in support of process, systems, and policy redesign• Effectively manage cross-functional projects that support the business strategy.• Other duties as assigned.
Qualifications
Years of Experience: • 7-10 years of experience . Degree: • Bachelor’s Degree . Certification: N/A . Skills & Abilities: • Excellent analytical skills with a proactive nature • Strong organization skills with a drive to meet deadlines • An affinity for accuracy and efficiency • Proficiency in Microsoft Excel, Word (including mail merge) and Outlook• Strong verbal and written communication skills • An aptitude for prioritization and multi-tasking • Strong collaboration skills • A drive to learn and apply new concepts quickly • Experience with Salesforce CRM preferred
