Leads and supervises team responsible for provision of support center customer service excellence to meet the needs of Molina members and providers. Â Ensures issues and needs are addressed fairly and effectively, and in alignment with Molina values. Â Demonstrates accountability for delivery of product and service information, identifies opportunities to improve the member and provider experience, and supports continuous quality improvement initiatives related to member/provider engagement and retention.
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Essential Job Duties
• Provides leadership and oversight for the member and provider support center; ensures exemplary service is delivered according to Molina goals/objectives/policies/procedures and regulatory requirements, and demonstrates accountability for performance and financial outcomes. Â
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Addresses more complex member inquiries, questions and concerns in all related areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.
• Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public.
• Achieves individual performance goals as it relates to call center objectives.
• Demonstrates personal responsibility and accountability and leads by example through individual performance.
• Ensures compliance with contractual and regulatory requirements.
• Recommends and implements programs to support member and provider needs.
• Supports projects and special initiatives as appropriate.
• Sets a positive example for others and builds the Molina culture by modeling the Molina mission, vision and values in daily actions.
• Hires, trains, develops and manages team; demonstrates accountability for team performance and achievement of department-specific goals.
• Models dynamic leadership for support center representatives; develops team to focus on delivering great health care/customer service to underserved populations.
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Required Qualifications
• At least 5 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, including 3 years of call center experience, or equivalent combination of relevant education and experience.
• Strong customer service skills.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Ability to work cross-functionally across a highly matrixed organization.
• Strong verbal and written communication skills. Â
• Microsoft Office suite and applicable software programs proficiency.
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Preferred Qualifications
• Management/leadership experience.
• Systems training/experience for the following : Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Managed care/health care experience.
• Broker/health insurance license.
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To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Learn more about this Employer on their Career Site
