As a full-time, Member Service Supervisor, you will oversee the Member Services call center team and serve as a point of contact for escalated issues.  The ability to multi-task and prioritize competing responsibilities, along with superior problem-solving and top-notch communication skills are necessary for success in this position. Responsible for maintaining relationships within the organization and outside vendors. Works directly with and supports the Director of Benefit Relations to implement new processes while maintaining superior service.

ESSENTIAL JOB FUNCTIONS

• Provide direct supervision to the Member Services Team, through effective leadership and team management, to yield world class customer service 
• Assign, prioritize and delegate efficiently based on business needs and skillfulness of staff; plan, assign and direct work to balance workloads
• Analyze data for root cause analysis
• Monitor inbound call, chat and email volume to ensure defined service goals are met/exceeded
• Regularly review call recordings, chat transcripts, email responses and other assigned work to ensure compliance and quality
• Manage agent shifts and hours to ensure adequate coverage and approve Paid Time Off requests
• Promote employee development and perform annual employee reviews, checkpoints, team meetings and one-on-one meetings
• Assist with all aspects of call center and phone system – facilitating training, programming of software/hardware, perform system updates, POC with all staff and phone vendors
• Coach representatives to effectively deescalate calls and handle member concerns with one touchpoint
• Handle sensitive employee, provider and member PII and PHI, along with HIPAA compliance
• Work directly with Provider Relations Supervisor to discuss and resolve all escalated issues
• Research and resolve claim disputes and member complaints
• Participate in new hire onboarding and training
• Partner with various software development teams to define, test and deliver new software features
• Coordinate and drive cross-departmental projects
• Grow skills through progressive project work
• Identify gaps in documentation and coordinate with management
• Serve as an end user tester for software updates and upgrades
• Perform activities and functions of related lower-level personnel as assigned or required

*The above statements describe the general nature and level of work being performed by individuals assigned to this classification. This is not intended to be an exhaustive list of all responsibilities and duties required of this position.

QUALIFICATIONS

EDUCATION: Associate degree or equivalent work experience. Bachelor's degree is preferred.

• EXPERIENCE: At least 3-5 years of full-time experience in a health-care or administrative role; 1-2 years of experience managing, coaching, team building and speaking in front of a large group through video calls; 1 -2 years of experience in a call center platform (Avaya, RingCentral, Genesys or similar)
• Must be presently authorized to work in the U.S. without a requirement for work authorization sponsorship by our company for this position now or in the future.
• Must maintain a residence in Pennsylvania throughout employment.

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to work under pressure, manage multiple tasks, while remaining calm and professional
• Efficient problem solver able to apply experience to escalated issues
• Ability to establish and maintain effective working relationships; must be inclusive and approachable
• Skilled communicator and active listener; able to de-escalate difficult situations
• Proficient in MS Office Suite, Content Server, Genesys
• Ability to quickly troubleshoot technology and system issues
• Ability to monitor and evaluate quality and performance management
• Ability to plan, coordinate, and direct the work of direct reports
• Strong writing, research and analytical skills; ability to articulate thoughts clearly and concisely
• Strong problem-solving skills and ability to manage effectively through ambiguity and complex situations
• Considerable knowledge of performance evaluation and employee coaching
• Ability to follow and ensure departmental compliance and HIPAA regulations

WORK ENVIRONMENT/PHYSICAL DEMANDS

• This is a remote position within the Pittsburgh, PA area.  In-office work may occur periodically based on business need.   The Carnegie office may also serve as a backup location when/if the need arises.
• Work is performed in a home office environment and may require:
  • occasionally lifting 0 – 20 pounds.
  • prolonged periods sitting at a desk and working on a computer.

To perform this job successfully, an individual must be able to perform the essential job functions satisfactorily.  Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions described herein.  Since every duty associated with this position may not be described herein, employees may be required to perform duties not specifically spelled out in the job description, but which may be reasonably considered to be incidental in the performing of their duties just as though they were actually written out in this job description.