[Hiring] Member and Provider Service Supervisor @WellSense Health Plan

Role Description

The Member and Provider Service Supervisor is responsible for ensuring the delivery of outstanding customer service, resolving issues, and delivering accurate information to WellSense members and providers. This role includes:

• Participating in the recommendation, development, and implementation of quality service strategies to improve member and provider satisfaction.
• Direct supervision of Member and Provider Service Center staff.
• Ensuring all necessary tools and resources are available to meet or exceed state contractual requirements and corporate standards.
• Identifying and resolving service barriers (claims, eligibility, enrollment, prior authorization, and benefits).
• Collaborating with the Member and Provider Service management team to provide high levels of customer service.

Qualifications

• Bachelor’s degree or an equivalent combination of education, training, and experience is preferred.
• Three or more years call center experience preferred.
• Three or more years experience in healthcare or managed care is preferred.
• Three or more years supervisory experience preferred.

Requirements

• Implementing department policies, procedures, and standards.
• Daily analysis of call volumes and adjusting staff resources to meet demands.
• Ensuring monthly compliance with corporate standards.
• Establishing and refining processes to support Member & Provider Services.
• Monitoring staff compliance with established workflows.
• Resolving first line policy questions referred by staff.
• Ensuring staff has the technology and training needed for customer service.
• Identifying training opportunities to enhance customer service.
• Conducting one-on-one quality feedback sessions with direct reports.
• Taking client/customer calls and filling in for Assists as needed.
• Detail-oriented with excellent organizational skills and ability to multi-task.
• Monitoring call trends to identify service issues.
• Assisting in budget planning.
• Contributing to development and maintenance of member and provider materials.
• Flexibility with shifts and hours as needed.
• Maintaining current knowledge of WellSense policies and regulations.
• Leading project activities and resolving project issues.
• Representing the department on cross-functional initiatives.
• Performing other tasks as needed to meet goals.

Benefits

• Full-time remote work.
• Competitive salaries.
• Excellent benefits.

Compensation Range

$57,500 - $83,500. This range offers an estimate based on the minimum job qualifications and considers various factors such as education, experience, skills, and certifications.