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Hi,
I am Saurabh Kumar in the process of identifying excellent employee for our client's needs. Please review the requirement that I have posted below & let me know if you would like us to present your resume.
Job Title: Senior Manager Call Center
Location: Carrollton TX
Duration: Full Time/ Permanent
Note: 8+ years of strong US Healthcare Operations management background in Call Center, Provider Network, and Regulatory functions (can be combined)
Job Description:
Under the supervision of the Associate Vice President, the Senior Manager will be primarily responsible for developing and designing strategies for Operations Management within the Business Process Services Team. This role will be responsible for leading the day-to-day operations including but not limited to providing support, direction, and management supervision. This position also assists with various internal tasks that ensure a high level of overall client satisfaction and ensure government regulations and contractual deadlines and commitments are satisfied.
Candidates must demonstrate exceptional dedication to customer service, strong communication skills, and a commitment to improving operational efficiencies.
Duties and responsibilities
Lead a large-scale team in multidisciplinary roles to support BPS Operations
Direct Management of Call Center, Provider Network and Configuration, and Regulatory Operations for Medicare Line of Business (PACE and MA)
Ensures any agreements and related SLAs are being met, and policies adhered to, by the entire organization.
Establish and maintain strong relationships with key stakeholders (internal and external) to ensure seamless communication and collaboration.
Handle client complaints and provide appropriate solutions and/or alternatives; following-up to ensure resolution.
Managing the day-to-day resources to support the increasing expectations of our customers, partners, and providers.
Achieving performance targets in line with business objectives for assigned areas.
Call-Center Management
Lead and manage member and provider services teams by providing guidance, coaching, and performance management to ensure a high level of productivity and professionalism.
Develop and implement customer service strategies and policies to enhance member and provider satisfaction and achieve service level targets.
Monitor and analyze key performance indicators (KPIs) to identify trends, areas for improvement, and opportunities for operational efficiency.
Collaborate with cross-functional teams, such as Claims, Enrollment, Benefit Configuration to align customer service objectives with overall business goals.
Oversee the implementation and utilization of customer service technologies and tools to optimize efficiency and improve the customer experience.
Provider Network and Configuration Management
Manage team to ensure client rules, benefits, and fee schedules are loaded correctly in the core claims processing system/s.
Oversee support tickets are worked timely.
Ensure policies and procedures are in place to maintain effective coordination and control of configuration and provider network activities.
Partner with client's IT Team for configuration requirements, data analysis, and testing support.
Regulatory and Compliance Management
Manage team to ensure reports are submitted timely and accurately (Encounters, RAPS, and PDEs)
Review clients' regulatory requirement to identify critical gaps and provide regulatory and compliance strategy for the best path forward.
Ensure policies and procedures are in place to remain compliant with the regulatory and contractual requirements set forth by the Centers for Medicare and Medicaid Services (CMS) and the State.
Manages the monitoring of internal and external processes and functions to facilitate compliance with the regulatory requirements. Assesses risks, identifies trends, and prepares reports. Gathers and reviews information and data for the regulatory compliance dashboard. Presents results and recommendations for improvement to management.
Experience and Skills requirement for this role:
8+ years of strong US Healthcare Operations management background in Call Center, Provider Network, and Regulatory functions (can be combined)
5 + years of experience managing large (50+ FTE) multi-skilled teams in Payer functions.
2+ Years of experience leading transformational programs/project management, with special focus on organization, process, and automation projects
A track record of building, achieving, and exceeding targeted business results/KPIs.
Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
Strong stakeholder management experience, with the ability to build and strengthen relationships within the business at all levels.
Evidence of building talented high performing teams
Should you be interested, please send me a copy of your resume in Word/PDF format along with the following details ASAP.
Full Name:
Current Location:
Work Authorization:
Salary / Rate expectation:
Thanks & Regards
Saurabh Kumar
InfiCare Technologies| 22375 Broderick Drive #225 Dulles VA 20166 |
703.652.4804 Direct | saurabh@infiCareTech.com
Staffing Services since 2001 MBE Certified
*Recipient of Annual si100 Award*
The annual si100 award is given to companies "which display the characteristics of long-term visibility, sustained growth, business focus, profitability and customer and employee value-creation. The esteemed list consists of companies that have made a mark in their area of expertise."
InfiCare Technologies
