Member and Provider Services Supervisor

Overview

Member and Provider Services Supervisor

Monthly metric bonuses based on performance!

No selling, no weekends!

Monday – Friday; Day Shift

Health, Dental, Vision, and Life Insurance as well as Paid Time Off, Paid Holidays and Paid Training!

Summary:

Premier Administrative Solutions (PAS) is a Third-Party Administrator (TPA) which provides a wide range of administrative services to insurance companies, sharing organizations, insurance marketing organizations, and employers. One such service is Member and Provider Services, where inbound calls, outbound calls and correspondence from members or covered individuals and their providers are managed.

This service is provided subject to service level agreements which mandate a high level of service, including telephone service, accuracy, call resolution and satisfaction. The Member and Provider Services Supervisor provides leadership and coordinates activities of the call center department.

To best serve its clients and their members, PAS’ Member and Provider Service Department is organized into Teams, each serving a specific client and/or product they offer. Each Team is managed by a Supervisor, responsible for delivering service excellence andprovidingthe tools to do so.

Responsibilities

Essential Duties and Responsibilities:

Participating as a member of the Member and Provider Services Department Management Team, including strategy, budgeting, staffing projection and quality improvement.

Creating a culture within the Team of exceptional service to members and their providers, as well as transparency in reporting results, trends and issues to Senior Management and clients.

On an ongoing basis, monitoring the phone system and Team queues to ensure that service levels (i.e., percentage of call answered by a live operator in 45 seconds, average speed to answer, longest hold time and abandon rate) are met, and Team member production measured by number of calls handled and average length of call is reasonable based on each Team member’s experience.

During exceptionally busy times, supporting the remainder of the Team in meeting service levels by signing into a queue and handling calls.

Responsible for managing the Team’s staffing, including analysis of call patterns, service trends and attendance so that requires service levels are met.

Responsible for ensuring that any messages left for the Team or scheduled outbound calls occur within 1 working day of the message being left or the request for an outbound call.

Responsible for ensuring that Representatives take an active role in ensuring that any support requested from other Departments for Open calls is received, and the member or provider is provided with updates on progress toward resolving an issue.

Responsibility for ensuring that any correspondence received by the Team, including mail and electronic mail is answered within 1 working day. Any email issue noted as urgent should be responded to within 4 hours.

Assuming responsibility for expertise in all facets of the client being serviced by the Supervisor’s Team, including programs, plans, marketing organizations, contacts and relevant Policies and Procedures.

Working with PAS’ Documentation Coordinator and Trainer to ensure that reference materials for the Team’s client are accurate, up-to-date and designed in such a manner as to create efficiency in call resolution.

Within the Team, ensuring that appropriate lines of communication and standards for call escalation are established. This may include formal or informal designation of senior representatives or team leaders to support the remainder of the team.

Ensuring that all Team members understand the importance of privacy and accuracy in the information they provide, and work with Enterprise Risk Management (ERM) Auditors on any quality issues which emerge.

Act as a liaison with clients for escalation of service issues or program questions, establishing a strong working relationship and client trust.

Assists with the development of Policies and Procedures for the Member and Provider Services Department.

Supervisory Responsibilities: 2 employees in a growing department

Primary Performance Expectations:

Performance review for each Supervisor is ongoing, with formalized reviews quarterly. The results of the quarterly reviews will determine increases in responsibility, compensation, and incentive compensation. Performance expectations or goals are as follows:

Team Telephone Service Levels

Service Level: Minimum of 90% of calls reach a live Member and Provider Service Representative within 45 seconds.

Average Speed to Answer: The average speed to be answered for all calls with be less than 40 seconds.

Abandon Rate: For all calls reaching the Team’s phone queues, less than 5% will result in the caller hanging up prior to reaching a Representative.

Individual Production Level

Handle a minimum of 150 MPS transactions per week. A transaction is defined as an inbound call, outbound call where the intended target for the call is reached, or a written response to inbound mail or e-mail.

Team Quality Level

A minimum of 3 calls per Representative will be audited and the overall Team score must average a minimum of 93% of higher.

Team Satisfaction Level

An annual Satisfaction Survey will be provided to the relationship manager for clients managed by the Team and the Team must be graded with a score of at least 4 out of 5 (Highly Satisfied).

Qualifications

Qualifications, Experience, and Competencies:

A minimum of at least 2 years in a Supervisory role in an inbound Customer Service Center, servicing health insurance policies or benefits.

A minimum of at least 5 years working in an inbound Customer Service Center, including acting in the role of a Representative, Supervisor or Auditor/Trainer.

Strong organizational, interpersonal, and motivational skills.

Excellent written and verbal communication skills.

Certificates, Licenses, Registrations:

None

Computer Skills:

Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook

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.

Job Locations US-FL-Clearwater

ID 2024-2625

# of Openings 1

Category Management