Member Services Quality Team Lead

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member.

We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit [webpage] for more information about the Amida Care culture.

We are actively seeking a highly motivated, innovative and experienced leader to join our team as the Senior Director of Provider Relations. This position will be a member of the senior management team. Compensation will be commensurate with experience.

Position Summary:

The Member Services Team Lead position is responsible for ensuring quality and efficient customer service is provided to members and providers through the daily supervision and monitoring of Member Services Representatives (MSRs) and Third Party Vendor Customer Service team include hiring, motivating, recognizing, and rewarding, coaching, counseling, training, and problem solving. This position under the direction of the Quality Supervisor supports the development of operational performance improvement insights gleaned from service calls and call trends. Collaborating with service management from across the organization and with vendors the position will be responsible for recommending operational improvements that enhance the member and provider service experience by collaborating in Quality call evaluations and training/coaching sessions, calibration calls and oversight of the plan’s Secret Shop program.

Responsibilities:

Assist with daily QA team oversight and support
Conduct call monitoring, evaluations, training, and coaching sessions with agents and vendors as needed
Monitor and audit a percentage inbound, outbound, and escalated calls on a weekly basis for all agents, assist call center agents and team leads in the achievement of quality and productivity measures including documentation of all calls by using side-by-side, random monitoring of calls and by providing coaching and feedback
Routinely review QA team member performance to determine areas of opportunity on both an individual and team level
Support daily, weekly monthly & quarterly completion and audits on daily & monthly basis
Serve as Quality Subject Matter Expert to our Call Center and vendor teams
Coordinating and facilitate Call Calibration sessions with member facing staff and vendor teams and tracking outcomes.
Prepare and analyze internal and external call quality reports
Work closely with Service Center Team Leads and Supervisors to assist with training for both new and existing team members and assist in the development and management of QA training and process documentation
Identify and support other opportunities for quality improvement across the team.
Work with QA Supervisor to drive continuous optimization of CRM and ensure Member facing staff are trained on new deployments.
Conduct random post calls survey and track and report member feedback.

Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.

Amida Care requires that all candidates selected for employment must provide proof of full Covid-19 Vaccination upon acceptance of an offer of employment.

EDUCATION REQUIRED

High School Diploma. College degree preferred or an equivalent combination of education and related experience required.

EXPERIENCES AND/OR SKILLS REQUIRED

Minimum three (3) years’ experience in providing Customer Services in Medical, Health Care or Health Plan setting
Experience in Call Center monitoring and coaching preferred (but not required)
Proficiency in Microsoft Office (Word, Excel, Access, Outlook, PowerPoint and Publisher) and Adobe.
Strong verbal and written communication skills.
Must have strong critical thinking and prioritization skill.
Ability to meet deadlines in a fast-paced environment.
Exhibit ability to communicate effectively in front of large and small groups and in one-on-one discussions
Demonstrate understanding 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.
Demonstrate ability to read and communicate effectively in English.

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