Medicare Advantage Customer Service Manager

Unclassified - Somerville, MA

Full-time - Manager

Somerville, MA

About the position

The Medicare Advantage Customer Service Manager at Mass General Brigham Health Plan plays a pivotal role in overseeing the daily operations of the Customer Service Center. This position is integral to ensuring that the center meets its performance standards while adhering to regulatory, contractual, and corporate policies. The manager is responsible for fostering a culture of service excellence and efficiency among a diverse and multi-generational staff. This role requires a proactive approach to leadership, focusing on the development and mentoring of supervisors and staff to create a high-performance service culture aligned with the organization's strategic goals and core values. In addition to managing day-to-day activities, the Customer Service Manager is expected to actively participate in cross-functional teams that address strategic business projects, including cost-saving measures and compliance with regulatory requirements. The manager will utilize industry-standard operational metrics to assess individual and departmental performance, ensuring that all service level expectations are met. This includes maintaining compliance with HIPAA regulations and ensuring the confidentiality of member information. The role also involves making staffing adjustments based on operational needs, monitoring productivity, and generating performance reports. The manager will be responsible for fostering a positive work environment, addressing conflicts, and motivating employees. Effective communication is crucial, as the manager will need to inform and engage staff while cascading important information throughout the organization. The position requires a commitment to diversity, equity, and inclusion, ensuring these principles are integrated into all aspects of the work environment.

Responsibilities

• Act as a key advocate for customer service excellence within the Customer Service Center and across the organization.
• Provide leadership, development, and mentoring of supervisors and staff to create a high-performance service culture.
• Meet short and long-term Call Center metrics and goals, focusing on enhanced first point-of-contact resolutions.
• Ensure compliance with all contractual service level expectations and regulatory requirements.
• Continuously assess current metrics to reflect customer preferences and needs accurately.
• Ensure departmental compliance with HIPAA privacy regulations and maintain confidentiality of member information.
• Adjust staffing based on operational needs and monitor productivity of customer service representatives.
• Generate performance reports and maintain harmony among workers, addressing conflicts as necessary.
• Inform, engage, inspire, motivate, and actively listen to employees.
• Communicate and cascade information to employees in a timely manner and participate in cross-organizational programs.
• Identify/create processes and align resources to accomplish key objectives, assigning clear accountability for objectives and deadlines.
• Hire, evaluate performance, and supervise the work of all direct and indirect reports, following organizational policies.
• Set clear goals and objectives, using metrics to measure performance and hold employees accountable.
• Provide coaching to improve performance and hold regular development meetings.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Build strong relationships to designate Mass General Brigham Health Plan as a people-first organization.

Requirements

• Bachelor's degree required or equivalent combination of training and experience.
• 5-7 years of related job experience managing staff and supervisors in a high-volume call center, preferably within a managed care environment.
• Knowledge of Call Center metrics, leading practices, and relevant technologies required.
• Demonstrated ability to design and build effective and diverse work teams.
• Working knowledge of claims processing and enrollment operations.

Nice-to-haves

• Strong aptitude for technology-based solutions.
• Current in healthcare trends.
• Demonstrated forward, visionary thinking; ability to see what is and envision what could be.
• Ability to develop, introduce, defend, and gain support for new ideas and approaches.
• Excellent leadership skills and leadership track record.
• Ability to translate and communicate complex topics effectively to various audiences.

Benefits

• Health insurance
• Opportunities for advancement