Team Leader Member Relations JHP

Team Leader

This position reports to the Member Relations Manager. The team leader works with minimal direction in coordination with the Member Relations Supervisor and Management. Responsibilities include but are not limited to responding to complex external and internal inquiries in a professional, informative, and courteous manner (10-15% on the phone). This role requires mastering and demonstrating skills and concepts within the call center environment. Demonstrates the ability to think outside of the box to identify, resolve, and assist the team with the handling of complex inquiries. Support and represent the Member Relations team. Assist in formulating department guidelines, coordinate projects and assist with staff training when needed.

Primary responsibilities include :

• Directs staff in performance according to standards of practice, state and federal regulations, accreditation agencies and company policies and procedures.
• Serves as the point person / technical resource for issues regarding all lines of business.
• Anticipate and identify causes of interruption in unit functions and takes appropriate action to meet performance expectations.
• Develop, among staff, a consciousness for the need for teamwork to attain departmental objectives. As well as direct staff in a constructive and positive manner to foster positive employee relationships.
• Recommend candidates for hire to the Manager based on subjective and objective findings identified by using a standardized interviewing tool.
• Ensures that reports are completed, accurate, and timely to meet regulatory and company regulations.
• Attend and assume a leadership role in Team meetings, staff meetings, and all external cross-functional meetings.
• Attends external meetings as representative of Health Partners Plans and represent department at meetings which have an impact on Call Center operations and reports on the same.
• Assist Member Relations Representative with accurate benefit information for callers.
• Assist in the coordination of special assignments including reports and departmental projects.
• Provide phone coverage on high call volume days to provide telephone support as required and handle calls which escalate beyond the Member Relations Representatives abilities.
• Act as a liaison to member's who request one-on-one assistance.
• Provide Floor Support.
• Member Relations Macess Inventory Oversight.
• Responsible for the documentation of operating procedures.
• Collaborate with leadership and support team to set up touch point meetings with an agenda. Provide recommendations and feedback based off team performance.
• Tracking / Trending of call volumes and escalated matters, reporting on trends and issues that impact the Member Relations Department.
• Coordinate cross-functional and interdepartmental initiatives.
• Schedule and assist with the facilitation of team meetings, and huddles.
• Adhere to the following turn-around times for issue resolutions via e-mail, Macess, in-person, etc.
• Follow Department guidelines on response time and resolution (acknowledgement) for standard inquiries and, expedited issues.
• Evaluate staff quality performance utilizing coaching tools as a resource for improvement.
• Mentoring staff using intense one on one coaching sessions as a means of performance enhancement.
• Facilitate mini group and individual training sessions to support staff with knowledge gaps to perform across functional discipline.
• Review staff's monthly audit appeals for accuracy and appropriateness of submission.
• Provide supervision and support to Call Center staff, including participating in the monthly.
• On Call rotation cycles which provides 24 / 7 support.
• Attend SQC and Fair Hearing meetings to provide interpretation and feedback as needed.
• Other duties as assigned.

Key job requirements include :

Work shift : Rotating (United States of America)

Worker Sub Type : Regular

Employee Entity : Health Partners Plans, Inc.

Primary Location Address : 1101 Market, Philadelphia, Pennsylvania, United States of America

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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