OH SPBM Call Center Manager
Summary
The Call Center Manager will oversee a primarily in-bound, call center and a Clinical Prior Authorization Center serving the Ohio Department of Medicaid.
Call center representatives respond to provider and member inquiries. The manager will monitor KPIs and ensure that all contractual obligations are met.
They will instill a culture of quality improvement and invest in staff development.
Your role in our mission
Manages the SPBMs dedicated call center team by overseeing hiring, training, staff recognition, and performance evaluation and management.
Fully engages in real-time performance monitoring to facilitate achievement of service level agreement requirements.
Ensures all policies and procedures are up to date.
Ensures inquiries and issues are researched and resolved in compliance with state-defined policies, procedures, and criteria.
Ensures clinical, operational, and experiential standards.
Coordinates with Quality personnel to facilitate quality improvement initiatives.
Ensures staff are initially trained and works with the Training Coordinator to assess ongoing training needs. Approves content.
Recommends staffing adjustments based on historical trends or current trend trajectory.
Develops useful management and client reports.
Liaise with subject matter experts regarding industry best practices, process improvement and customer service to maintain state-of-the-art Contact Center.
Meets regularly with client regarding contractual requirement updates.
Escalates matters to the state, when warranted.
Other duties as assigned / required.
What we're looking for
Bachelors degree in business management, Insurance, Healthcare or related field preferred or equivalent work experience.
Prior management experience required.
1-2 years of managed care, insurance, or pharmacy benefit management call center experience required.
Pharmacy experience required.
Medicaid experience preferred.
What you should expect in this role
Remote
Supporting an operation on Eastern Standard Time
Business travel as needed 25% or less.
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