Customer Service Analyst

Lumeris•St. Louis, MO

2d•$63,600 - $84,300

About The Position

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. Position Summary: Provides oversight of external partners and vendors to drive achievement of contractual service levels, CMS requirements and other expectations in pursuit of a 5 Star member experience. Supports internal stakeholders, clients and on occasion, members or providers to resolve complicated inquiries. Analyzes complex information and data and translates it into easy to digest presentations, dashboards, knowledge articles and other communications. Adept at working under limited time constraints while delivering quality outputs.

Requirements

Bachelor’s degree or commensurate experience with the demonstrated ability to perform the responsibilities outlined in the Job Description.
Minimum of three years of health plan operations experience or commensurate experience with the demonstrated ability to perform the responsibilities outlined in the Job Description.
Knowledge of healthcare regulations, Lumeris’ MA benefits and CMS guidelines and policies.
Strong commitment to Service Excellence and driving a BEST-IN-CLASS customer experience that results in a Five Star CMS rating.
Strong PC skills including intermediate abilities using Microsoft Word, Excel, PowerPoint and Smartsheet.
Experience with Wrike or the ability to learn how to utilize Wrike.
Experience with Genesys and Pure Insights or the ability to learn how to utilize these workforce management tools.
Proficiency developing new and documenting current process maps and proposing improvement opportunities.
Excellent written and verbal communication skills including the ability to professionally interact with associates at all levels.
Demonstrated ability to be proactive, flexible, enthusiastic, resourceful and detail oriented.
Must be self-motivated and a self-starter and able to deliver at a high-level with limited direction and oversight.

Nice To Haves

Lean Six Sigma or related experience

Responsibilities

Research and resolve complex issues and inquiries from vendors, clients and internal stakeholders.
Audit vendor performance including quality, accuracy and other contractual service levels. Present findings and address deficiencies.
Collaborate within Lumeris and with vendors and clients to drive timely communication, develop or improve processes and create or approve knowledge articles, training materials and other knowledge resources.
Identify trends and develop recommendations to address issues and improve processes and practices to elevate the member and provider experience.
Represent Customer Service as a member of the Operations Implementation Team (OIT).
Compile and present data, reports and other information to illustrate performance results and action plans related to performance gaps.
Participate in audits, assist with corrective action plans and drive other process, performance and compliance activities.
Collaborate with cross-functional teams to develop process maps and identify improvement opportunities.
Identify and document requirements for new products, solutions, markets and other initiatives and participate in user acceptance testing.
Other work and duties as assigned.