Medicare Advantage Customer Service Manager at Mass General Brigham Health Plan in Somerville, Massachusetts

Job Description:

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.


Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.


We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.


The Manager of the Customer Service Center is responsible for managing the day to day activities of the Call Center. The Manager is responsible for ensuring compliance with all applicable performance standards and regulatory, contractual, and corporate policies and procedures. The Manager must ensure maximum effectiveness of call center staff with a focus on efficiency and service excellence. The CSC staff is a highly diverse and multi-generational staff working in a dynamic and ever-changing environment.


The Manager will be expected to utilize industry-standard operational metrics to measure individual and departmental performance. In addition to managing the day to day activities of the Call Center, the Manager is an active, visible participant on many cross-functional teams which address strategic and business projects such as cost savings measures, infrastructure efficiencies, regulatory and contractual requirements, and break/fixes.



Responsibilities:



• Act as a key advocate for customer service excellence within the Customer Service Center and across the organization.


• Provide leadership, development and mentoring of the supervisors and staff in order to create a high performance service culture that is aligned with Mass General Brigham Health Partners' strategic goals, objectives, and core values.


• Meet the short and long-term Call Center metrics and goals that incorporate enhanced first point-of-contact resolutions and seamless service processes.


• Ensure that all contractual service level expectations are achieved and that the department is in compliance with all regulatory requirements and standards. Continuously assess whether current metrics are accurately reflecting customer preferences and needs.


• Ensure departmental compliance with HIPAA privacy regulations. Provide leadership to ensure member information is kept confidential through verification, access and restriction of information when appropriate.


• Makes necessary changes in staffing based on day of week and other anticipated and unanticipated events.


• Monitors productivity of customer service representatives and generates reports.


• Maintains harmony among workers and addresses conflicts.


• Inform, engage, inspire, motivate, and actively listen to employees.


• Make decisions that put the needs of the people we serve-our members, providers, brokers, and employers-front and center.


• Communicate and cascade information to employees in a timely manner and actively participate in the success of cross-organizational programs and initiatives.


• Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations.


• Hire, participate in, and/or recommend development measures and disciplinary actions up to and including termination; evaluate performance and supervise the work of all direct and indirect reports following established organizational policies, procedures, and practices.


• Set clear goals and objectives, use metrics to measure performance, and hold employees accountable. Provide coaching to improve performance and holds regular development meetings.


• Hold self and others accountable to meet commitments.


• Ensure diversity, equity, and inclusion are integrated as a guiding principle.


• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.


• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.


• Other duties as assigned with or without accommodation.



Qualifications

Qualifications:



• Bachelor's degree required or the equivalent combination of training and experience.


• 5-7 years of related job experience managing staff and supervisors in a high-volume call center preferably within a managed care environment required.


• Knowledge of Call Center metrics, leading practices, and relevant technologies required.


• Demonstrated ability to design and build effective and diverse work teams.


• Working knowledge of claims processing and enrollment operations.



Skills/Abilities/Other Details:



• Demonstrate Mass General Brigham Health Plans core brand principles of always listening, challenging conventions, and providing value.


• Bring fresh ideas forward by listening to and working with employees and the people we serve.


• Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner.


• Strong, demonstrated track record of an ability to execute on time, on budget, and on scope.


• Strong aptitude for technology-based solutions.


• Ability to inject energy, when and where it's needed.


• Current in healthcare trends.


• Demonstrated forward, visionary thinking; ability to see "what is" and envision "what could be."


• Ability to develop, introduce, defend, and gain support for a new ideas and approaches.


• Excellent leadership skills and leadership track record.


• Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required.


• Ability to view the long-range trends and cycles of the business and industry and see the "big picture."


• Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.


• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.


• Excellent interpersonal skills, including the ability to influence others at all levels of an organization.


• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.


• Unquestionable integrity.


• Motivates and encourages staff; leads through change and adversity. Makes decisions as needed and builds consensus as appropriate. Communicates and cascades information to employees in a timely manner and actively participates in the success of cross-organizational programs and initiatives.


• Sets clear goals and objectives and uses metrics to measure performance and hold staff accountable. Provides coaching to improve performance and holds regular development discussions with direct reports. Recognizes staff for their contributions.


• Inform, engage, inspire, motivate, and actively listen to employees.


• Make decisions that put the needs of the people we serve-our members, providers, brokers, and employers-front and center.


• Communicate and cascade information to employees in a timely manner and actively participate in the success of cross-organizational programs and initiatives.


• Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations.


• Hire, participate in, and/or recommend development measures and disciplinary actions up to and including termination; evaluate performance and supervise the work of all direct and indirect reports following established organizational policies, procedures, and practices.


• Set clear goals and objectives, use metrics to measure performance, and hold employees accountable. Provide coaching to improve performance and holds regular development meetings.


• Ensure diversity, equity, and inclusion are integrated as a guiding principle.


• Normal office working conditions.


• Remote, Hybrid or onsite



EEO Statement

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.