Director of Call Center Quality and Compliance
Company: MetroPlus Health Plan
Location: Newark
Posted on: January 10, 2021
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Job Description:
About NYC Health + HospitalsMetroPlus Health Plan provides the
highest quality healthcare services to residents of Bronx,
Brooklyn, Manhattan, Queens and Staten Island through a
comprehensive list of products, including, but not limited to, New
York State Medicaid Managed Care, Medicare, Child Health Plus,
Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
As a wholly-owned subsidiary of NYC Health + Hospitals, the largest
public health system in the United States, MetroPlus' network
includes over 27,000 primary care providers, specialists and
participating clinics. For more than 30 years, MetroPlus has been
committed to building strong relationships with its members and
providers to enable New Yorkers to live their healthiest
life.Position OverviewThis position will serve as a central point
of contact for quality needs to identify trends and improvement
opportunities on an individual, team, and call center levels with
the objective of improving customer satisfaction while meeting
regulatory and compliance requirements. Working in collaboration
with the customer service management team, this role is responsible
for the oversight of the quality for call center including
compliance, audits and training and knowledge management.Job
Description* Proactively identify, analyze, remediate, or modify
operational processes that eliminate excess capacity, defects in
workforce models and forecasts to deliver best in class workforce
plans.* Serve as the subject matter expert for various project
implementation teams.* Works with the Senior Director of Customer
Service to develop/maintain department performance goals and
objectives which is cascaded down to each individual team member as
appropriate.* Partner with Learning and Organizational Development
to ensure that new hire and ongoing training represents training
and organizational best practices, and all contractual requirements
are met.* Ensures the availability of a robust knowledge management
system that has a comprehensive library of desk manuals that
contains all plan information and processes; and maintains the
knowledge management in accordance with contract ensuring that all
CSRs utilize the system as a source of information.* Oversees the
call center's quality assurance and implements any necessary
corrective actions to ensure consistent application of all laws,
regulations, and policies.* Works directly with Compliance team to
plan internal audits, prepare for external audits and plan
readiness assessment by collecting and evaluating internal
processes ensuring alignment with regulatory requirements.*
Complete regular analysis (monthly and quarterly) of call center
performance reports and ensure accuracy and timely distribution of
reports that provide insight to performance.* Oversight of Call
Center vendor performance and conduct monthly evaluations based on
agreed upon SLAs.* Ensures MetroPlus Health's Call Center follows
and complies with all contract, state and regulatory agency
guidelines and standards.* Develop and manage annual operations
budget. Track invoices and expenditures ensuring careful evaluation
of trends and expenses that impact budget.Minimum Qualifications*
Bachelor of Science in Healthcare, Business Administration degree
or higher strongly preferred* Lean Six Sigma certification (Yellow,
White or Green Belt) preferred OR demonstrated quality management
and continous process improvement experience* Minimum 5-7 years of
Call Center/Contact Center management experience* Experience with
call center systems (e.g. Avaya, Cisco, NICE, Verint, Salesforce,
etc.)* Demonstrated experience with metrics and analysis including
workforce planning, productivity, SLAs and KPIs required.* Proven
ability to develop and manage budget.* Computer Skills: Advanced
skills with suite of Microsoft products including Outlook,
Word,Visio, Power Point and ExcelProfessional Competencies*
Integrity and Trust* Charisma* Customer Focus* Functional/Technical
skills* Excellent Written/Oral Communication* Strong People
Management
Keywords: MetroPlus Health Plan, Newark , Director of Call Center Quality and Compliance, Executive , Newark, New Jersey
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