Job description
LE0006 MSO of Puerto Rico, LLC
EDUCATION AND EXPERIENCE
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
POSITION DESCRIPTION
The Position of Transportation Unit (TU) Supervisor will report directly to the Transportation Unit Manager. The selected person will be responsible for planning and organizing the activities of the call center operator team under their responsibility, and to monitor the efficient compliance of the assistance activity. Also is responsible for ensuring that Member’s receive their optimal level of benefit coverage for services that require or not prior authorization. Responsible for assuring appropriate coverage of pre-authorization calls from members and providers.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Monitor the operation of the team, distributing the workload of each of its members, depending on the objectives set, in order to provide an adequate service to the end customer. Assures that the Transportation Unit Coordinators performs an assessment to the member in order to identify the appropriate transportation services according to benefits and medical necessity. Collaborate with the TU Medical Director, TU Director and TU Manager for the benefit of the member, providers and company internal process. Provide TU Director with performance management, goal setting, coaching, training, and development of the CSRs. Assures appropriate coverage of PA or not PA calls, fax and emails or other ways requests of service/s during normal operation hours or as requested, to achieve the metrics and standards set by the organization. To address all those claims/complaints of high complexity, assuming responsibility in the response posed to the customer, to try to minimize the negative incidents of operations carried out in the clinics and increase the quality of the service provided. An issues and resolutions log will be kept by the supervisor and discussed weekly with Transportation Unit manager or PAU Management staff.
Analyze and control the work planning of the team's shift, keeping up to date the
information of the tasks performed by each of the members, and periodically report the status of the activity of your shift, as well as the incidents arisen, to maintain an adequate organization of the service.
Responsible for ensuring TU operational reports are submitted thoroughly and timely during established individual meetings with TU Director. Responsible for maintaining maximum and manages caseloads by measuring case assignments, closures, outcomes and utilization review standards across discharge planners and coordinators. Fosters an environment of collaboration between coordinators, social workers and other Department’s staff. Reviews client grievances and participates in conflict resolution with clients and staff as needed. Maintains update with the Centers for Medicare and Medicaid Services (CMS) regulation changes in the Transportation Services and helps to develop new policies and procedures for the unit. Establish two-way communication channels between staff and company, helping to maintain a good working climate that allows obtaining the optimal performance of the staff and their integration in the company. Develop and serve as a coach of the team of coordinators, evaluating and evaluating its staff periodically to propose the appropriate corrective or motivating measures. At least monthly, conduct individual sessions/meetings and weekly team meetings to review such things as: department goals, service measures, recognizing performance and inform MMM changes, updates and customer issues. Perform and Monitoring Quality Audits. Ensure in collaboration with the TU Manager that required Program reports are completed in an accurate and in a timely manner. Assist on capacity analysis based on strategic growth or new needs. Perform other duties such as special projects that are related to the essential function of the job.
EDUCATION AND EXPERIENCE
- Associate Degree or equivalent.
- 2 years as call center supervisor, preferably in the healthcare industry.
- Experience in “Call Center Management Systems” (“CMS”), preferably AVAYA.
- Hands-on experience with the modern treatment techniques and technologies trends.
- Friendly attitude and team player.
- Excellent communication, interpersonal and leadership skills.
- Good organizational and time-management skills.
GENERAL ABILITIES AND KNOWLEDGE
- Electronic Medical Record knowledge, preferred.
- Knowledge of and ability to apply professional call center principles, procedures, and techniques.
- Analytical and strategic think.
- Proficient in Microsoft Excel.
- Effective verbal and written communication skills along with proper telephone etiquette.
- Performs duties in a tactful and professional manner.
- Computer knowledge.
- Ability to respond to a high volume of work and always maintain a polite and professional manner.
- Must demonstrate positive attitude. Strong interpersonal skills.
- Able to function with frequent interruptions.
- Ability to prioritize workloads for maximum efficiency.
- Able to sit for extended periods of time without compromising work performance.
- Teamwork: ability to work in a team environment to provide solutions to problems
- Can work flexible schedules including weekends and holidays.
- Business modeling techniques.
- Technical writing.
LANGUAGE SKILLS
- Bilingual (English and Spanish).
- Respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
- Write articles for publication that conform to prescribed style and format.
- Effectively present information to top management.
MATHEMATICAL SKILLS
- Ability to calculate figures and amounts such as proportions, percentages, and volume.
REASONING ABILITY
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
PHYSICAL AND MENTAL DEMANDS
- Working on computer and telephone for long periods of time.
- Ability to effectively utilize office telephone equipment; repetitive motion using fingers and forearms in data entry, manual dexterity to access filing system, use fax and copy machines.
- This position requires that weight be lifted, or force be exerted up to 10 pounds.
ENVIRONMENT AND WORKING CONDITIONS
- Normal office environment.
- The noise is typically moderate.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
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