Customer Escalation Manager

This position leads a team of seasoned provider and member call center representatives who handle complex and escalated service inquiries, including claims, as well as standard service requests. A key focus is on provider inquiries and complex claims and related issues. This position also oversees HEDIS Care outreach campaigns, member recertification and other outbound campaigns as needed.
The manager partners with call center management colleagues to continuously evaluate and improve member experience, in part through developing and continuously updating Amida Care’s Service Quality Program, which defines the member and provider service requirements for the internal and vended call centers and other service touchpoints.
The manager will be a steward of needed improvements as defined by the voice of the provider and member, and will represent these valuable insights at the appropriate workgroups and committees and in day-to-day interactions with resources, including executive resources, from across the organization.
• Bachelor’s degree in Business, Public Administration or Marketing or an equivalent combination of education and related work experience required.
• Three (3) years of call center management experience required.
• Must have strong health plan knowledge with a minimum of three (3) years of significant experience in claims, provider contracting and service, plan benefits, and customer (member &/or provider) experience.
• 5+ years of management experience required.
• Prior Salesforce or other CRM experience a significant plus.
• Knowledge of process improvement methodologies desired.
• Travel to vendor sites up to 20% of time may be required.
• Effective communication (verbal and written) and presentation skills with the ability to communicate to a variety of levels within the organization, vendors, and outside organizations, including executive leadership.
• Demonstrated proficiency in the use of Microsoft Office (Word, Excel, Power Point and Access).
• Demonstrated cultural humility and understanding of and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.

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