Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely about 40% in year-over-year revenue growth in 2018 . Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and One of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.
Who You’ll Be Working With:
Reporting to the Manager, MA Call Center/Customer Service, this individual will play a critical role in executing Evolent Health’s mission by managing and overseeing Customer Service Representatives in the MA Customer Service and Call Center department. The Supervisor will be responsible for directly overseeing and coaching staff to ensure the team delivers the highest possible quality service to our Medicare Advantage customers, including members, providers and other constituents. This position will lead the team in achieving and maintaining service levels and customer experience, understanding that service has a direct impact on plan performance.
What You’ll Be Doing:
- The Supervisor provides direct supervision to a team of Customer Services Representatives ensuring the team handles all customer inquiries in a timely, professional and courteous manner, including phone calls or correspondence regarding benefit, eligibility, and all other inquiries and requests as well as proper intake and handling of complaints/grievances.
- This position is responsible for managing staff in all day-to-day activities to consistently meet established customer service/call center service levels/metrics, schedule adherence and quality standards.
- Monitors, develops and coaches members of the team; drives performance by providing direct, consistent feedback and direction on performance in a timely manner to ensure continued productivity and quality standards are met.
- Handles escalated service issues, including “request for supervisor/manager” calls; review and respond to complex issues and questions.
- Assists the Manager with department workload and establishes work standards to promote efficiency and productivity including maintaining the daily schedules and work flow, forecast call volume and determine appropriate staffing levels; effectively communicate results, targets and strategies to team members.
- Provides assistance and data needed to maintain and monitor departmental performance standards and reports; review and analyze weekly and monthly department performance reports; address performance issues and implement needed interventions and coaching individual employee performance to meet and exceed production and quality metrics.
- Responsible for staying current and maintaining a working knowledge/understanding of CMS Medicare Advantage related guidelines, processes and protocols, including program audit requirements and ensure that adequate in-service education is available to staff.
- Provide assistance to Manager with data analysis and trend data to improve quality and efficiencies and implement process improvement; provide guidance and support to personnel towards resolution of related problems with an emphasis on root cause analysis and resolution of problems.
- Under direction of Manager ensure "best practices" are followed and continually seek efficient and innovative processes, technologies and approaches to optimize use of resources and enhance operations; incorporate a view of transactions from a member perspective and ensure actions taken enhance the member experience.
- Develop deep understanding and maintain an operational knowledge of all computer and telephone systems, call center reporting system and Customer Relationship Management system as well as other required proprietary systems for health assessment reporting; assist in the assessment and resolution of computer system issues and/or enhancements.
- Coordinate with Manager to work with Compliance and internal audit department on CMS releases and internal quarterly audit finding; develop and ensure corrective action plans are executed as a result of compliance and quality assurance audits.
- Serve on various committees, participate in designated cross department work group and attends required meetings
- Perform other duties and projects as assigned.
The Experience You’ll Need (Required):
- 3-5 years experience with customer service/call center operations within a managed care organization, health plan, or third party administrator
- 1-3 years of progressive management/supervisory experience supporting customer service, call center or related departments
Finishing Touches (Preferred):
- Associates Degree or equivalent
- 3-5 years of progressive management/supervisory experience supporting customer service, call center or related departments
- Prior supervisory experience within a Medicare Advantage call center/customer service department
- Deep understanding of Medicare Advantage regulations and guidance including, but not limited to the Medicare Managed Care Manual and the Medicare Prescription Drug Benefit manual
- Experience with CMS audits
- Extensive experience with operations, service and process engineering implementations
- Entrepreneurial mindset geared toward the creation, execution and continuous improvement of health plan operations and implementations
- Excellent written and oral presentation skills
- Demonstrated exceptional active listening and communications skills
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.