Member Services Supervisor

HealthPartners is hiring a Member Services Supervisor in our Riverview Member Services department. This position is responsible for managing the member services call center staff with teams ranging from 15-20 staff members. They are accountable to ensure that Member Services staff are doing everything possible to meet the department standards. They are responsible for managing both quality of service and quantity of calls handled by each representative.

This position is accountable for the accurate and timely resolution of written, and telephone inquires from members, providers and group leaders regarding all aspects of health plan related issues. This includes a general overall understanding of the plan and how it works including benefits, sales and marketing processes, eligibility, network, health plan policy and procedures and claims status and explanation.

ACCOUNTABILITIES:

1. Responsible for the supervision of staff, including having the authority to hire, transfer, lay off, promote, discipline and discharge, train, reward and review performance of employees. Ensures compliance to organizational and departmental policies and procedures.
2. Manage incoming call volume taking into account staffing, schedule, anticipated volume, mailings, training, etc. Make necessary changes to ensure that we meet our performance guarantees.
3. Represent HealthPartners in responding to escalated, potentially sensitive or politically motivated customers. This includes responding to customers on behalf of HealthPartners executive staff including the CEO. Improper handling of such cases can result in negative publicity or loss of business.
4. Call elimination through problem identification, analysis and reporting, and process improvement.
5. Manage customer issues to ensure timely resolution.
6. Assures that the quality of telephone and written responses to customer inquiries meet standards.
7. Acts as a liaison between departments to assure timely and accurate responses to various department inquiries.
8. Provides feedback on individual performance to reporting staff on a routine basis.
9. Identifies and researches problems, implements or recommends solutions depending on the scope of the problem
10. Investigates administrative problems and/or procedure discrepancies by designing and analyzing system reports.
11. Monitors production standards and modify based on system enhancements and/or new procedures.
12. Provides training that will enhance customer service skills.
13. Provides the catalyst for a harmonious working environment through teamwork and encouraging high levels of morale and motivation.
14. Participates in departmental planning and the implementation of new policies and procedures.
15. Assures that HealthPartners' affirmative action program is properly communicated, implemented and adhered to in an effort to achieve projected goals on both a corporate and divisional basis.
16. Participates in business continuity planning and implementation.
17. Performs other duties as assigned.

REQUIRED QUALIFICATIONS:

• At least four years experience in the health insurance industry.
• Advanced verbal skills.
• Concise and accurate written communications skills.
• Advanced human relation and leadership skills.
• Advanced analytical skills.
• Advanced problem- solving skills.
• Demonstrated skill in planning, organizing and time management.
• Ability to make logical decisions independently and meet deadlines.
• A detailed understanding of the health care industry, including internal operations of an insurer and provider network arrangements.
• Computer/PC knowledge.

PREFERRED QUALIFICATIONS:

• Previous supervisory experience.
• Previous experience with computer systems.
• Thorough knowledge of HealthPartners' member and provider contracts.
• Working knowledge of HealthPartners' processing system.
• Medical background
• 4 years degree with emphasis in human relations and business.
• Familiarity with ACD systems.

DECISION-MAKING:

The incumbent must have the ability to work and make logical decisions independently. Recommendation that affect the overall department should be documented and discussed with all involved parties for group consensus.