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Member Engagement Operational Supervisor

Location : San Juan PR
Job Type : Direct
Hours : Full Time
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services

Job Description :
Responsible for the supervision of the activities and operation of the division. Responsible for the compliance of local and federal regulation and the development of policies and procedures to provide quality and efficient member engagement to clients and providers. Responsible for the efficient and continuous communications between the representatives and other departments inside and out of the organization.

 



  • Manages staff to ensure that all efforts are being made to attain goals, in terms of daily production and KPI’s. 

  • Coordinate and monitor the service workflow to balance and meet call center expectations and member engagement objectives. 

  • Prioritize work assignments and build back-up plans to support goals. 

  • Monitor the quality of phone calls and visits of the representatives. 

  • Tracks individual achievement to prepare reports related to the organization’s enrollment process. 

  • Develop policies and procedures of the area to comply with CMS. 

  • Oversees external call center suppliers in special periods like AEP, OEP, LIP. 

  • Assure compliance with all the policies and procedures established by the division. 

  • Interfaces with other division to improve operational procedures 

  • Participates in staff meetings to ensure the development of quality control for the organization’s products and services. 

  • Works with Enrollment Department to up-date member information. 

  • Participates in the implementation of tactical plans, follows up on assigned tasks, projects, or objectives to ensure that expectations are met. 

  • Prepares production reports, statistics and presentations when required. 

  • Assist in special projects and / or initiatives of the corporation. 

  • Provide recommendations to achieve the Division’s and Company’s goals. 

  • Hires, trains, coaches, counsels, motivates and evaluates the performance of direct reports. Establishes disciplinary actions when necessary and promotes employee performance recognition when applicable. 

  • Responsible for preparing, assigning tasks, monitoring workflow and monitor day to day execution and employee activities. 

  • Other tasks as assigned by the management and that are essential.


Required Qualifications :


  • Bachelor’s Degree in Business Administration or related area with three (3) to five (5) years of experience preferable in the health insurance industry or in Telemarketing or Tele sales area.


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