Health Plan Service Specialist Int.
Health Plan Service Specialist Int. - Corona, CA
***1 of5 HPSS Intermediate openings*** The Health Plan Service Specialist functions as a member of the Management Team. Interacts as necessary with Team Managers, Quality Assurance and staff to support the development of the Customer Service Representative; provides feedback to Team Managers that may be used in corrective action. May provide backup support to Team Managers. May assist CSRs with complicated member issues and inquires. Essential Functions: - As part of action planning and improving performance capabilities, HPSS is responsible to provide coaching and feedback to the CSRs and work collaboratively with the Team Managers to create a plan of action to improve the overall performance of the CSRs. Utilizing results from side by side observations and assisting with complicated member issues and inquires. - At the direction of their Operations Manager, engage in individual development of CSRs in order to reduce AHT, increase Quality Assurance scores which will improve member satisfaction and member retention. Also acts as a backup for TM's when needed based on the needs of the department. - Responds and resolve all escalated issues ensuring first call resolution, responsible for timely intervention of service quality issues and the Department of Managed Health Care inquires/complaints, assists CSRs with complex problems and questions. Accurately document results of assisting CSRs with complicated member issues and inquires. - Support training through delivery of specific modules and post-classroom training support, as needed. - Support User Acceptance Testing (UAT), to ensure successful role out and implementation of new systems to include but not limited to; applications and phone such as HP_CHATs and telephony Infrastructure across National sites. This will include pre-implementation and post implementation testing and support, as needed. Travel maybe required. - Support recruitment efforts in conjunction with the Operations Managers in the interviewing and hiring process of Health Plan Service Specialists, as needed. ***25% travel is required*** Qualifications: Basic Qualifications: - Minimum of 4 years of experience in a Call Center in either a health care or customer service field required. Must have completed the MSCC new hire training and have passed probation. Demonstrated proficient knowledge of Call Center policies, practices and systems required. - High School diploma or additional equivalent related experience in lieu of High School diploma. Preferred Qualifications: - Strong interpersonal and communication skills with emphasis on coaching, developing and facilitation. -Minimum of 4years of related experience in a customer service position, preferably in an HMO environment. - Prior MSCC experience desired. - Bachelor's degree in Business/Health Care Administration (or related discipline) or additional equivalent related work experience in lieu of bachelor's degree.