Job Summary: Provide leadership to the call center functions to support the established corporate goal of growth into multiple Markets and Products. Oversight of all service operations functions to ensure optimal service delivery to the entire customer base in existing and future lines of business, while meeting all internal and regulatory/ compliance goals.
Determine departmental strategies to effectively service customers and providers through the call center
Perform cost/benefit analyses’ for new technologies
Seek out new approaches to maximize departmental efficiencies
Periodically survey providers and customers to evaluate performance and establish base lines.
Periodically assess departmental performance through various corporate controls.
Ensure that corporate service level agreements (SLA) are met or exceeded
Develop and support staff standards to ensure quality encounters with customers and providers
Monitor all regulatory requirements and oversight of all submissions in existing and future lines of business.
Evaluate and trend grievance information and training evaluations to strengthen all programs.
Analyze data and identify trends monthly to ensure company expectations are met
Identify information system inefficiencies and formulate recommendations.
Keep abreast of new call center technology and service concepts.
Oversee preparation of internal budgets variances for the operational Departments.
Provide assistance in product financial forecasting and analysis to support the business goals.
Create comprehensive operational reports and present those reports on a weekly, monthly or annual basis, as required.
Develop and maintain an in-depth knowledge of the company’s business and regulatory environments.
Consult with applicable regulatory entities and legal counsel as necessary to assure vendor contracts meet all regulatory standards.
Assist in strategic and business planning.
Perform any other job related instructions as requested, with reasonable accommodation.
o Key decisions include:
o Development of strategy and product model
o Annual operating plan across markets & products
o Hiring of local staff
· Accountable for revenue and membership of all products
· Performance against operational/financial targets
· State and member satisfaction
· Development of products that serve member needs within set cost and quality targets
· Interact heavily with Ohio President, and Market Leaders
· Interact with functional owners of business partner organizations, as necessary
Bachelor of Science in business, healthcare, management, or related field or equivalent experience is required
Master of Business Administration (MBA), Public Administration (MPA), healthcare or related field is preferred
Seven to ten years’ in a call center environment is required
Five years’ call center management experience is required
Prior second level management experience is required
MCO experience is preferred
Advanced level experience in Microsoft Word, Excel and PowerPoint
Data analysis and trending skills
Staffing and forecasting experience preferred
Knowledge, Skills, and Abilities:
Knowledge of call center trends
Strong written and oral communication skills
Strong Customer Service orientation
Strategic management skills
Ability to adapt quickly to changing business needs
Ability to work independently and within a team environment
Attention to detail
Familiarity of the healthcare field
Critical listening and thinking skills
Strategic management skills
Ability to maintain confidentiality and act in the company’s best interest
Executive management skills
Decision making/problem solving skills
Energetic, enthusiastic, and politically astute
Ability to act with diplomacy and sensitivity to cultural diversity
Strong Conflict resolution skills
Planning, problem identification and resolution skills
The statements contained herein describe the essential functions of this position. This description is not an all-inclusive listing of work requirements. Individuals may perform other duties as assigned, subject to reasonable accommodation.
CareSource is a leading non-profit managed care company based in Dayton, Ohio. CareSource has been meeting the needs of health care consumers for more than 25 years.
To make a lasting difference in our members’ lives by improving their health and well-being.
At CareSource, our mission is one we take to heart. In fact, we call our mission our “heartbeat.” It is the essence of o...ur company, and our unwavering dedication to it is a hallmark of our success.
Transforming lives through innovative health and life services.