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   Current UPMC employees must apply in HR Direct

Service Coordinator Associate Supervisor (Camp Hill)

Description

Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. 


The successful individual will oversee a team of telephonic Service Coordination Associates (SCAs) that support Service coordination services for the Community HealthChoices Program. This position will also be responsible for the performance of the SCA duties. Manage daily operations of team members and coordinate activities of Service Coordinators in the community. Manage daily supervision and development of SCAs, daily escalated issues, and calls, develop and provide training to team members, assess the operational patterns of calls into the Hub, and make recommendations to improve performance. The role of the Supervisor of Service Coordination Associates must understand the causes of customer concern and can communicate these findings to Service Coordination Management as well as various internal and external parties. As well as other duties as assigned by SC Management. The individual will effectively monitor calls queues/volumes, using 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/monitor progress. These functions must be completed while also weighing the practical considerations and potential barriers that need to be overcome to successfully implement new programs and processes. Take a leadership role in the enhancement and implementation of processes, documentation, and workflows for the Service Coordination Associate. Facilitate and 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:

  • Responsible for the day-to-day service coordination functions through the management of the staff and activity which includes evaluation, monitoring, and approval of service plans. Supervise and monitor the ongoing performance of team members against department standards. Prepare employee performance reviews. Meet with team members at least on a monthly basis to provide ongoing feedback and training. Implement action plans to meet quality and production expectations. This includes Performance Management, Corrective Action, Performance Reviews, Identifying/Issuing Verbal Warnings, Supporting Career Pathing, and One-on-ones.
  • Support recruitment process through phone screens, scheduling and preparing, and conducting interviews. Participate in interviewing, hiring, and training of team members. Maintain and assist with employee timecard and Kronos oversight, FMLA, vacation time.
  • Create and maintain a positive working environment for all staff members, including daily encouragement, motivation, recognition, and positive feedback. Work cooperatively with internal departments in the identification of process improvements and development of department efficiencies.
  • Evaluate team performance reports from production systems in the moment and weekly/monthly, review with leadership and team members and drive performance improvement. Identify root cause of potential or existing problems. Assist in the resolution of difficult inquiries; provide expert certification of the CHC Services, benefits interpretation, and system support.
  • Maintain employee ensured confidentiality. Support other regions as requested during periods of backlog. Act as a mentor for other team leads and staff in other regions.
  • Identify trends in call data for clinical services team and assess patterns and make recommendations to improve operational performance. Monitor contacts/inventory throughout the day and adjust the resources.
  • Participate in appropriate departmental and organization committees, development and implementation of LTSS policies, goals and objectives., ICTs and Program development. Responsible for the operational functions of the LTSS Team primarily focused on the service coordination model, SCAs and service coordinators in the community.
  • Manage escalated issues, including working with the customer, identifying the root cause, and implementing a plan for prevention of future issues. Prepares, conducts and/or supports the delivery of Team Meetings and Staff Training to provide information to team members in a timely manner.
  • 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. Participate/Assist with testing enhancements and upgrades to the HealthPlaNET system and associated interfaces such as Canopy and MC400.
  • Manage special projects. Meet deadlines and turnaround times set by managers and department directors. Schedule based on business needs which could include weekends, evenings, and holidays.
  • Performs in accordance with system-wide competencies/behaviors.
  • Performs other duties as assigned.

 

Qualifications

High school degree is required. A bachelor's degree in a related field is preferred. 3-5 years experience in Insurance, Managed Care, Benefits Administration environment, Human/Social Service environment, or Customer Service environment is preferred. Prior high-volume operations experience strongly preferred. Previous supervisory experience preferred. Knowledge of the home and community-based service system and how to access and arrange for services preferred. MS Office/PC skills are required. Knowledge of medical terminology is preferred. High degree of professionalism, enthusiasm, and initiative daily. 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. Knowledge of Avaya telecom systems & CenterVu call management system strongly preferred.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct