Customer Care Manager

Hudson Health Plan, a not-for-profit managed care organization based in Tarrytown, NY, is recognized as a leader in quality improvement, customer satisfaction, and health reform advocacy.  Founded in 1986 by a coalition of community-based health centers, the organization services low-income people through Medicaid Managed Care, Child Health Plus and Family Health Plus insurance programs and has more than 70,000 members in New York's Hudson Valley.  The company is dirven by its mission: 'to promote and provide access to excellent health services for all people.'  Drawing upon its commitment to initiatives that support equitable access to quality health care, it fosters innovate technologies that enable clinical quality initiatives and streamline the eligibility determination and enrollment process into state-funded health coverage.

We are currently seeking a Customer Care Manager.

POSITION SUMMARY:  Supervises all aspects of Customer Care.  Handles calls from members and providers.  Attempts to resolve complaints and problems and/or refer calls to the appropriate department.  Supervises and evaluates Customer Care RepresentativesAssists the Customer Care Director in the development and implementation of office policies and procedures for Customer Care.Assists the Customer Care Director in the recruitment, supervision, and delegation of Customer Care Representatives.     Orients and trains Customer Care Representatives.Addresses all disciplinary issues and administers corrective action in a timely and accurate manner.  Develops, tracks, and distributes monthly reports on member issues to clinical staff and Quality Improvement/Utilization Management Committee.Conducts departmental Quality Assurance reviews.      Maintains Customer Care Procedure Manual and customer complaint log.    Serves as Plan liaison for transportation and other support services.   Assists other departmental supervisors in maintaining office communication.  Attends regularly scheduled Supervisors’ Meetings.Utilizes the ACD telephone system to generate reports, fulfills staff equipment needs, and manages call distribution, in order to foster and maintain an appropriate service rate. Ongoing analysis of all reporting, such as enrollment and newborns, to ensure optimum performance.Meets with Clinical Services Department management on a regular basis to review and resolve pertinent issues.  Meets with other department managers as needed.Performs all functions of  Senior and Customer Care Representatives.Process prescription and medical reimbursement.

 

QUALIFICATIONS:   BA/BS degree and five (5) years related work experience.  Experience in supervising and good communications skills. Call center experience a plus. Thorough knowledge of computerized office systems, medical terminology, and managed health care services.  Patient, and tolerant, with strong interpersonal skills.  Exhibits good judgment.  Ability to work independently; willing to share information and problems with other staff and management.  Bilingual a plus.