Supervisor, Member Services - Public Plans

Point32Health Supervisor Of Member Services

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

Under the general direction of the Manager, Member Services, the Supervisor of member Services is responsible for the direct supervision of the Member Services colleagues (Advocates, Sr. Advocates and Team Leaders). The Supervisor is responsible for maintaining up-to-date knowledge of Point32Health products and communicating changes to staff; providing accurate and thorough interpretation of Point32Health benefits, claims processes, eligibility and enrollment policies to members, staff and other internal customers. The Supervisor actively coaches, trains and monitors Member Services Advocates. The role is responsible for making recommendations and developing action plans to improve workflows, enhance the customer experience and also provide leadership and guidance to all team members. The Supervisor monitors team productivity, reports on issues, identifies opportunities for improvement, and satisfies corporate and customer service goals and objectives. The Supervisor may represent Member Services staff and their respective customers in related departmental or corporate initiatives.

Job Description

Team Management

Oversee daily operations of the service center team.

Schedule shifts and manage attendance.

Provide training and development for team members.

Performance Monitoring

Track and analyze key performance indicators (KPIs).

Conduct regular performance reviews of team members and provide feedback.

Implement strategies to improve team performance.

Customer Service

Ensure high levels of customer satisfaction.

Work to ensure calls and issues are being resolved on first contact

Handle escalated customer issues and complaints.

Develop and implement customer service policies and procedures.

Reporting and Analysis

Prepare and present reports on team performance and customer feedback.

Analyze data to identify trends and areas for improvement.

Use insights to make informed decisions and recommendations.

Communication

Facilitate effective communication within the team and with other departments.

Conduct team meetings and briefings.

Ensure team members are informed about updates and changes.

Quality Assurance

Monitor and evaluate calls for quality assurance purposes.

Provide coaching and support to ensure adherence to quality standards.

Develop and implement quality improvement initiatives.

Technology and Tools

Ensure the team is proficient with contacts center software and tools.

Troubleshoot technical issues and coordinate with IT support.

Stay updated on new technologies and recommend upgrades.

Compliance

Ensure compliance with company policies and industry regulations.

Conduct regular audits and assessments.

Address any compliance issues promptly.

Ensure all interactions are HIPAA compliant and adhere to state and federal regulations.

Continuous Improvement

Represent the voice of the customer by contributing to continuous improvement initiatives and providing feedback on member interactions and suggesting process enhancements.

Other duties or projects as assigned by your manager

Qualifications what you need to perform the job.

Education, Certification and Licensure

Required: Associate degree or equivalent work experience

Preferred

Bachelor's degree or equivalent work experience preferred.

Experience (minimum years required):

Required

3-5 years of customer service experience.

Preferred

Previous supervisory experience.

Customer service experience in health care, call center or corporate office.

Knowledge of medical terminology.

Prior experience training and working in a virtual/remote setting.

Skill Requirements

Leadership: Ability to inspire and motivate the team, providing clear direction and support.

Communication: Strong verbal and written communication skills to effectively interact with team members and customers.

Problem-Solving: Aptitude for identifying issues and implementing effective solutions quickly.

Analytical Skills: Ability to analyze performance data and make informed decisions based on insights.

Customer Service: Deep understanding of customer service principles and practices to ensure high satisfaction levels.

Time Management: Efficiently managing time and prioritizing tasks to meet deadlines and goals.

Technical Proficiency: Familiarity with contact center software and tools, and the ability to troubleshoot technical issues.

Conflict Resolution: Skills to handle escalated customer complaints and resolve conflicts within the team.

Adaptability: Flexibility to adapt to changing situations and new challenges.

Coaching and Mentoring: Ability to train, develop, and provide constructive feedback to team members.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

Must be able to work under normal office conditions and work from home as required.

Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.

May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

$63,969.29 -$95,953.93

Compensation & Total Rewards Overview

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

We welcome all

All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert

Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org