Job Details

Job Title

Leads and manages team responsible for provision of support center customer service excellence to meet the needs of Molina members and providers. Ensures issues and needs are addressed fairly and effectively, and in alignment with Molina values. Demonstrates accountability for delivery of product and service information, identifies opportunities to improve the member and provider experience, and supports continuous quality improvement initiatives related to member/provider engagement and retention.

Essential Job Duties

• Provides leadership and oversight for the member and provider support center; ensures exemplary service is delivered according to Molina goals/objectives/policies/procedures and regulatory requirements, and demonstrates accountability for performance and financial outcomes.
• Provides exemplary customer service to members, co-workers, vendors, providers, government agencies, business partners and the general public.
• Assists representatives with questions and escalated calls; recognizes trends and patterns in call types and engages leadership with suggested solutions.
• Identifies new opportunities for process development to improve support center operations and the member/provider experience.
• Recommends and implements programs to support member and provider needs.
• Develops and implements interventions to address deficiencies and negative trends.
• Provides technical expertise and handles escalated calls.
• Supports training needs of departmental employees.
• Ensures compliance with state and regulatory requirements.
• Collaborates with leadership and cross-functionally to coordinate problem-solving in an effective and timely manner.
• Achieves individual performance goals as it relates to call center objectives.
• Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
• Sets a positive example for others and builds the Molina culture by modeling the Molina mission, vision and values in daily actions.
• Hires, trains, develops and manages team; demonstrates accountability for team performance and achievement of department-specific goals.
• Models dynamic leadership for support center leaders and representatives; develops team to focus on delivering great health care/customer service to underserved populations.

Required Qualifications

• At least 7 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, including 5 years of call center experience, or equivalent combination of relevant education and experience.
• At least 3-5 year of management/leadership experience.
• Strong customer service skills.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Ability to work cross-functionally across a highly matrixed organization.
• Strong verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Systems training/experience for the following: Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Managed care/health care experience.
• Broker/health insurance license.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V