Job Description

Job Title: Supervisor, Call Center Clinical Operations- Health Plan
Job ID: 671042
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: UM Clin Ops
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:
UPMC Health Plan is hiring a full-time Supervisor, Call Center Clinical Operations to help support the Commercial Claims Management Department for its downtown Pittsburgh location at the US Steel Tower. This is a Monday through Friday daylight position. The successful candidate will manage daily operations of the Clinical Services Team. Manage up to (25) team members. Manage daily staffing, develop and provide training to team members, assess the operational patterns of calls into the center and make recommendations to improve performance. Perform the role the Supervisor of Clinical Service Operations must understand the causes of customer concern and have the ability to communicate these findings to the Clinical Operations Management as well as various internal and external parties. Use their knowledge and understanding of call trends and other information generated by numerous sources to identify opportunities to improve call center performance. Furthermore, articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress. These functions must be done while also weighing the practical considerations and potential barriers that need to be overcome too successfully implement new programs and processes. Take a leadership role in the enhancement and implementation of processes, documentation and workflows for the clinical operations area. Manage the attainment of quality, production and turnaround time goals within the parameters set forth by Health Plan policy and procedure and any state, federal, or accreditation agencies.

Responsibilities:
  • Create a positive working environment for all staff members, including daily encouragement, motivation, and positive feedback.
  • Ensure excellent customer service is provided and implement improvements to enhance the customer experience.
  • Identify trends in call data for clinical services team and assess patterns and make recommendations to improve operational performance.
  • Interface with Health Plan members, providers, account representatives and consumers via telephone, written correspondence and/or in person to answer inquires, resolve concerns and ensure 100% customer satisfaction.
  • Manage escalated issues, including working with the customer, identifying the root cause, and implementing a plan for prevention of future issues.
  • Manage special projects.
  • Meet deadlines and turnaround times set by managers and department director (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both).
  • Participate in interviewing, hiring and training of team members. Maintain a positive work environment through employee recognition and interaction.
  • Participate/Assist with testing enhancements and upgrades to the HealthPlaNET system and associated interfaces such as Canopy and MC400.
  • Prepare employee performance reviews. Meet with team members at least on a monthly basis to provide ongoing feedback and training.
  • Supervise and monitor ongoing performance of team members. Continually examine team performance against department standards.
  • Work cooperatively with internal departments in the identification of process improvements and development of department efficiencies.
  • Work in conjunction with Clinical Management staff to meet business objectives.

Qualifications

  • Previous Supervisory experience in a high volume call center required.
  • Associates or B.S. degree in Business, Health Care, Management or a related field preferred.
  •  2 years experience in health care insurance or health care industry preferred.
  • High degree of professionalism, enthusiasm and initiative on a daily basis.
  • Ability to work in a fast-paced environment a must.
  • Manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments.
  • Attention to detail is critical to the success of this position, with skills in customer orientation and the ability to deal with ambiguity.
  • Excellent planning, communication, documentation, organizational, analytical and problem solving abilities.
  • Ability to interpret and summarize results of various analyses in a timely and meaningful way.
  • Ability to effectively approach problem solving.
  • Ability to operate effectively in a very fast paced, complex environment required.
  • Must have an exceptional ability to multitask.
  • Knowledge of Avaya telecom systems & CenterVu call management system strongly preferred.
  • Thorough knowledge in MS Office and PC skills required.

    Licensure, Certifications, and Clearances:
    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $20.60 to $35.57

Union Position: No

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