Medicaid Customer Service Improvement Manager

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🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

💝 Customer Support

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Blue Cross Blue Shield of Arizona

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1939

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Blue Cross Blue Shield of Arizona is a health insurance provider offering a variety of health plans tailored to individuals, families, employers, and Medicare recipients. With a commitment to improving healthcare access and community health, AZ Blue provides self-insured and ACA-compliant health plans, including Medicare Advantage and Medicaid options. The organization focuses on connecting members with care through its extensive network, aiming for better health outcomes and community support.

📋 Description

• Provide oversight and guidance for complex customer service process improvement and segment-wide projects • Work with Medicaid Customer Service leaders to improve customer experience, monitor key metrics, and identify customer needs • Facilitate information exchange and issue resolution between internal business partners • Champion and implement strategic initiatives and provide direction to customer service staff on protocols for tracking and reporting results • Monitor and improve First Call Resolution, Customer Experience Index, and Net Promoter Score • Analyze routine reports and engage team leads in developing service enhancement tactics • Develop methods to measure the effectiveness of service strategy tactics • Establish protocols for communicating employee coaching needs across the department • Document and improve customer service processes • Distribute new and improved processes to customer service representatives and create and provide training • Guide and oversee department resource allocation, including ICS ticket resolution and coordination of claims, customer calls, and correspondence inventories • Provide claims and correspondence reporting while monitoring and improving metric results • Develop and communicate business cases supporting changes to business practices and processes • Respond to large group audits and RFPs as needed • Represent the department in meetings and decision-making processes • Provide data support, analysis, tracking, trending, reporting, and recommendations for commercial growth initiatives • Identify customer needs and insights and develop targeted action plans • Advance a culture of accountability, collaboration, results orientation, and customer centricity • Coordinate activities between multiple departments • Support leaders in performance management of staff • Provide claims, correspondence, and customer service knowledge to staff • Manage day-to-day and future customer service improvement activities • Identify and coordinate training needs, provide coaching, and recommend disciplinary actions based on performance trends • Evaluate and make recommendations regarding employment decisions • Perform other duties as assigned

🎯 Requirements

• 7 years of experience in health insurance operations • 5 years of supervisory or management experience • 3 years of process management experience • High School Diploma or GED in general field of study • Extensive knowledge of the health insurance industry • Excellent problem-solving and investigative skills • Excellent relationship building and communication skills • Strong skills in influencing others across teams • Strong written and verbal communication • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones • Intermediate skill in word processing, spreadsheet and database software • Intermediate PC proficiency • Ability to think critically and rise above challenges with a customer-centric focus toward achieving results • Strong familiarity with contact center metrics including ASA, Service Level, and First Call Resolution • Ability to effectively delegate and own accountability for ensuring work is being accomplished through others • Strong interpersonal and active listening skills • Ability to establish and maintain working relationships in a collaborative environment • Ability to manage process improvement projects and mentor people effectively • Maintain confidentiality and privacy • Prior management experience • Bachelor's Degree in general field of study (preferred) • 10 years of experience in health insurance operations (preferred) • 7 years of supervisory or management experience (preferred) • 5 years of process management experience (preferred) • Professional writing skills (preferred) • Advanced technical and professional mentoring and coaching skills (preferred) • Experience with managing, leading and continuously developing high performance teams (preferred) • Familiarity with Affordable Care Act policies and CMS requirements (preferred) • Intermediate to advanced knowledge of health insurance enrollment operations systems and transactions (preferred) • Familiarity with BCBSAZ commercial products and services (preferred) • Prior contact center management or contact center analytics experience (preferred) • Ability to optimize the use of resources to ensure cost effective operations (preferred)

🏖️ Benefits

• Hybrid workforce strategy called Workability offering flexibility with how and where employees work • Remote work opportunity • Health insurance products and services • Full-time employment • Equal opportunity and nondiscrimination commitment

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