Overview

Supervises the day to day operations and coordinates all work activities of VNS Health Plans Service Operations. Ensures a customer-focused operation that meets VNS Health Plans standards, goals, and objectives. Makes recommendations on operational improvements for the department. Works under general direction.

Compensation Range:$62,400.00 - $72,000.00 Annual

• Supervises the day-to-day operations of the VNS Health Plans Service Operations. Oversees the development, utilization, and evaluation of internal processes to ensure customer satisfaction, efficient operations, and accurate and timely resolution for all complaints and issues.
• Monitors the Automated Call Distribution (ACD) system to ensure department service commitments and goals are achieved. Ensures exceptional customer service and adherence to all organizational policies and procedures. Coaches staff to provide quality patient service, and prompt and accurate completion of all required documentation.
• Monitors the documentation of confinement service requests for regulatory compliance. Stays abreast of project time lines for the completion of service commitments and goals.
• Develops and maintains a strong ongoing customer service focus in dealing with internal and external customers and conveying a positive image of VNS Health Plans. Serves as a key liaison between other VNS Health Plans departments.
• Supervises Service Operations Staff on effectiveness of activities (e.g., responsiveness to call, number of calls, complaints issues, accuracy in setting up authorizations, etc.,), member satisfaction and retention. Works with the Manager of Service Operations to identify trends and variances; ensures timely and accurate resolution of discrepancies.
• Monitors performance of staff according to established standards. Coaches and develops staff as needed to ensure consistent, high quality customer service. Provides guidance and training to new and less experienced staff. Acts as a resource to new or less experienced staff in identifying solutions to unique or difficult calls/issues, and to ensure accurate, effective and timely resolution.
• Participates in Quality Assurance (“QA”) activities to maintain high levels of staff performance and aligns department performance with VNS Health Plans standards.
• Performs all duties inherent in a supervisory role. Participates in identifying staffing and operational needs, participates in hiring, training, evaluating and when necessary, termination of assigned staff in accordance to VNS Health policies and procedures. Collaborates with Manager, in conducting performance appraisal of assigned staff.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education:
Bachelor's Degree in Business Administration or related field or equivalent work experience required

Work Experience:
Minimum of three experience in a health plan or customer service environment required Working knowledge of Medicare /Medicaid and NYS and CMS regulations preferred Proficient in personal computer skills including Microsoft Word and Excel required Effective oral and written communication, interpersonal, and customer service skills required