Role Overview:
This position is responsible for the direct supervision of the Coordinator Concierge Service agents, (CCS’s). This position will be required to ensure and assist Coordinator Concierge Service agents in achieving and exceeding call and quality metrics with strict adherence to Regulatory Compliance requirements as defined by the State and the Centers of Medicare Medicaid Services (CMS). These highly motivated, extremely effective service specialists are responsible for providing targeted, personalized concierge level service for AmeriHealth Caritas Medicare members. The Concierge Service Coordinator’s job is to engage, consult and educate members based on unique needs, preference, and understanding of the AmeriHealth Caritas plan to help guide the member to quality and timely care. The Concierge Service Coordinator may support Medical Management, Member Services, Quality Teams, and other teams as deemed appropriate. The Supervisor of the Concierge Service Team must demonstrate clear understanding of the department’s functions and team processes.
Work Arrangement:
- This is a remote role within the United States
Responsibilities:
- Assisting in interviewing, selecting staff, training, writing DLP’s, ongoing coaching and development for the Concierge Service team.
- Managing the Coordinator Concierge Service associates to ensure timely introduction to the plan occurs, maintain monthly contact with high-risk members, contact identified members with Care Gaps/HEDIS related health conditions and assists them in accessing care through plan benefits and community resources.
- Monitors the Coordinator Concierge Service team in handling all in/outbound calls and transactions directly supporting assigned groups with problem resolution, educational materials, while developing strategies to increase health care adherence to reduce barriers to care.
- Responsible for record keeping, documenting call dispositions and/or compiling and generating reports as required.
- Ensuring the team addresses member concerns, fully assists and answers questions related to member and provider resources, benefits, enrollment, HEDIS preventative services, member bills, LTSS/Waiver services and other questions that may arise during their 1 year with the plan and/or while included in a certain member groups.
- Identify systematic trends and any emerging customer service issues which might impact member satisfaction.
- Monitors inbound and outbound calls from members and other stakeholders for content, accuracy and conformity to appropriate policies and conducts random monthly quality audits on the CCS agents, implements and monitors effectiveness of associated systems, downtime procedure and handles/resolves escalated calls.
- Maintains productivity and quality standards and meets monthly with staff to discuss individual results in relation to established performance standards.
- Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.
- Assists in auditing in/outbound calls from staff in collaboration with the Customer Experience team with the intent of identify gaps in knowledge, coaching/refresher training opportunities and delivery of a high level of customer experience.
Education/ Experience:
- Associate’s Degree required or equivalent work experience, Bachelor's Degree preferred
- Valid Health Insurance License required or must successfully obtain within 6 months of start date
- Minimum of 3 years of healthcare experience in a Medicare and/or Medicaid environment
Other Skills:
- Proficient PC skills with Microsoft Office Suite (Word, Excel, etc.).
- Excellent problem solving and organization skills.
- Ability to work independently or as a team.
- Ability to navigate through multiple software systems simultaneously.
- Strong interpersonal communication skills.
- Ability to maintain positive relationship with both internal and external customers.
- Prior supervisory experience in Outreach or Contact Center environment.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Your career starts now. We’re looking for the next generation of health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.