Direct delivery process and day-to-day operational handling of all customer initiated corporate escalations, including ensuring appropriate prioritization and customer complaint trend analysis. Serve as conduit to senior enterprise leadership with established communication path for escalation events. Drive BCBSNC adherence to state and federal regulations regarding complaint handling.
Develop stakeholder escalation framework and processes, and partner with Core Service Directors and senior leadership to incorporate escalations as part of the customer service strategy
Oversee escalation requirements, paths, and operations for contact teams to hand-off member calls to ensure escalated contacts are handled and resolved in compliance with BCBSNC standards
Oversee HICS/DOI complaint processes and ensure member issues are being resolved in accordance with BCBSNC service agreements and relevant regulations to mitigate risk
Monitor escalation and complaint trends and operate cross-functional team to identify root causes, referring recommendations for operational change or training to Business Advisory team
Report operational updates and escalation trends to the VP Core Service, providing expertise and addressing customer-interfacing issues driven by larger CGSO operations environment
Partner with Learning and Development to ensure staff is properly trained in and executes on established service quality and conflict resolution best practices
Partner with Core Service Command Center to plan capacity needs and monitor service performance
8 years of experience in a call center environment
An equivalent combination of education and experience that provides the incumbent with the knowledge, skills, and abilities required
5 years of progressive leadership experience
Experience executing innovative initiatives and projects
Experience in healthcare industry – or other complex financial service environment.
Strong knowledge of call center technologies including self-service, web, chat as well as inbound/outbound telephony.
Experience in leading and implementing project execution.
Experience in leading/facilitating strategic development and execution.
Demonstrated track record of passionate commitment to customer satisfaction and value.
A significant focus and demonstrated track record of strong people leadership and structuring a team based work environment is essential. Leadership experience should extend to large groups of people.
Demonstrated success in coaching, giving constructive feedback and developing employees.
Excellent problem solving and consultative skills; and the ability to proactively identify and resolve issues and opportunities.
Ability to respond to rapidly changing priorities and promote flexibility/change management techniques.
Excellent communication (written and verbal) skills and proven ability to develop and deliver high impact presentations to senior executives
Strong negotiation and influencing skills are essential to engage, lead and direct employees outside own organization
Experience developing, implementing, and monitoring budgets.
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina. Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care ? in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the... health and well-being of North Carolinians.
Our company is a not-for-profit with headquarters in Durham and major operations in Winston-Salem and Fayetteville. In all we employ more than 4,500 North Carolinians and serve more than 3.7 million customers.
Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.