Manager Medicare Member Services

Capital Blue Cross•Harrisburg, PA

1d•Hybrid

About The Position

This position is responsible for direct oversight of operational and personnel management activities of the Medicare Member Services unit. The Manager will directly lead front-line staff and is responsible for daily performance management. The Manager will also maintain productive and collaborative working relationships with internal and external partners.

Requirements

Ability to effectively communicate in written and verbal form to varied audiences on both simple and complex issues.
Ability to coordinate and direct activities of each unit to meet quality and productivity standards.
Ability to lead, motivate, evaluate, and develop personnel.
Ability to collaborate cross-functionally and work effectively in a matrix environment.
Proficient skills with Microsoft Office (Word, PowerPoint, Excel, and SharePoint).
Knowledge of Managed Care and Medicare Advantage Contracting principles.
Knowledge of Medicare Program and regulatory processes and requirements surrounding claims processing and appeals & grievance functions.
Working knowledge of Microsoft Office Suite, including Word, Excel, Project Manager, and Power Point.
5 years experience in a call center environment
1 year staff, team lead or project lead experience.
Experience managing multi-disciplinary initiatives preferred.

Responsibilities

Monitor team performance against Key Performance Indicators (KPIs) and develop action plans to maintain/improve performance
Provide coaching and/or mentoring for front-line staff to ensure performance expectations and regulatory requirements are met
Perform root cause analysis to Identify trends and top drivers related to member dissatisfaction and develop action plans to reduce member complaints
Perform research and analysis relative to current or future service functions and present recommendations for process improvements
Monitor budget vs. actual expense reports each month and contribute to annual budget input process