This job opportunity is no longer available.
This page has been archived for your
reference. You can try to continue to this position on the employer's website
or try a new search. Inquiries related
to this position should be directed to the employer.
Description
Job Description
Job Title:
Director Clinical Call Center Operations RN
Job ID:
10876
Location: Virginia Beach, VA
Full/Part Time:
Full-Time
Regular/Temporary:
Regular
------------
Email to Friend Save Job Apply Now
------------
Responsibilities
Grade: 21
NCC Clinical Recruiter: J. Mays
JOB SUMMARY: Incumbent will provide leadership, direction, operational and administrative procedures including Contact Center Administration, and organizational development initiatives. Incumbent will also develop and implement policies and procedures that ensure service level achievement and precertification turnaround times in accordance with company, contractual, State and Federal requirements. This key resource is accountable for the tactical management and coordination of departmental staff to ensure consistent customer satisfaction and quality of service. The role will manage the achievement and maintenance of all performance goals for the teams in their span of control, and contribute toward the attainment of the National Contact Center and Precertification goals and objectives.
PRIMARY RESPONSIBILITIES:
1.Responsible for the ongoing coordination and management of key operational resources assigned to contact center operations resolving issues related to members and providers for clinical services.
2.Creates an atmosphere of learning and improving clinical decision making skills
3.Develops policies, programs, and procedures to ensure the successful communication and education of members and providers relating to telephonic (inbound and outbound), web based and fax inquiries.
4.Responsible for contact center operations for NCC Clinical Services. Responsible for planning, organizing and managing all contact center activities including policies and procedures, organization structure, staffing, technology, training, Quality and adherence scores, HIPAA and OIG/EPLS compliance, facilities, reporting and related activities.
5.Serves as the department liaison for the Health Plan in the areas of all operational issues/errors.
6.Generates and submits statistical reports on performance for designated tasks.
7.Responsible for monitoring and assessing performance of Phone, Fax, ECF, NICU, and project teams.
8.Evaluates statistics to identify areas of concerns; identifies trends and issues across entities that are impeding the ability to provide high quality service and collaborates with the Director, NCC Performance Improvement to develop initiatives to reduce defects and improve overall operating efficiencies.
9.Promotes the use of best practice initiatives and other customer service enhancing initiatives.
10.Develops strong relationships with primary internal partners, practicing excellent customer relations and attention to customer needs
11.implements new processes as developed by the Director, NCC Process Improvement.
12.Provides proactive and on-going communication to designated internal customers regarding policies, procedures and systems through regularly scheduled meetings, ad hoc meetings, and telephone calls arranged and/or presented by the incumbent or assigned resources.
13.Ensures action plans are in place and shared across internal partners to address corrective actions and preventative measures for all service issues to enhance operational efficiency.
14.Leads the clinical management team and works with other contact center operations leaders. Ensures resolution of issues and provides long-term solutions to other functional areas.
15.Communicates changes and impacts to functional areas and aligned Health Plans on operational matters.
16.Develops and mentors a high performance team with high levels of productivity, adherence, attendance and quality. Maintains a focus on associate satisfaction and morale.
17.Actively contributes to assembly and operation of a strong, diverse and customer-focused team through effective recruiting, training, coaching and team building. Works with direct reports to build and execute individual development action plans providing coaching for individual development needs. Selects, develops and evaluates staff to ensure the efficient operation of the function. Provides leadership and direction to department staff as appropriate to ensure the quality of departmental work outcomes and deliverables.
18.Responsible for administering Human Resources policies; conducts performance evaluations and maintains and appropriately updates all information in direct report files.
19.Other duties as assigned.
EDUCATION AND EXPERIENCE:
Education
Required:
Bachelor's degree in nursing or equivalent clinical field
Years and Type of Experience Required:
Required:
Minimum of 7 years of relevant work experience and at least 3 years management experience in a UM Managed care environment
(Internal) Demonstrated proficiency as a Clinical NCC Manager.
Preferred:
Managed care experience with a Medicaid/Medicare plan administration.
Specific Technical Skills
Required:
Advanced understanding of contact center technology and terminology.
Advanced level MS Office skills.
.
Certifications or Licensures
Required:
Registered Nurse
Other:
Required:
Management skills for all levels of staff (exempt and non-exempt).
Ability to interact and communicate to and at all levels.
Ability to set and execute a strategy.
Excellent verbal and written communication skills.
Strong working knowledge/experience in the areas of expense management and cost controls.
Strong analytical and problem solving skills.
Conflict management skills.
Strong interpersonal skills.
Demonstrates initiative, is proactive in problem resolution, has the ability to multitask successfully.
SCOPE INFORMATION
# Direct Reports: 3
# Indirect Reports: ~150
Budgetary $ Responsibility:
PHYSICAL REQUIREMENTS:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
Ability to communicate both in person and/or by telephone.
Must be able to travel as needed and adhere to AMERIGROUP travel policies and procedures.
Equal Employment Opportunity
In accordance with state and federal laws, employment offers are tendered solely on the basis of qualifications without regard to race, religion, color, national origin, age, sex, marital status, sexual orientation, handicap (including disabled veterans) or Vietnam Era veteran status.
AMERIGROUP administers pre-employment drug testing as a condition of employment and a satisfactory criminal history background report.
------------
Email to Friend Save Job Apply Now
------------
Details:
Job Id:
692316A3
Posted / Updated:
4/9/2010 3:32:30 AM
Map
Careers & Community for Talented People with Disabilities