Member Services Senior Manager in San Antonio, Texas at University Health System- San Antonio

POSITION SUMMARY/RESPONSIBILITIES

Directs, supervises, and assists the activities of the Member Services Quality Monitoring and Training Unit which includes developing and maintaining of quality and training of staff. Works with departmental leadership to improve training and results from audits including but not limited in analysis of data for deliverable and /or reports. Leads, manages and is responsible and knowledgeable for ensuring all aspects of all compliance/regulatory/contractual standards federal and state, to include accredited organization and entities. To include identifying of potential high-risk situations from internal audits, providing documentation, timely response, and coordination with Community First departments including leading and organizing as needed meetings required to ensure that gaps/finding are met Ensures that all forms of communication and/or updates from these agencies and/or accredited agencies are maintained in the training module. Supporting the other units within Member Services as needed and/or as directed by the Directors of Member Services.

Responsible and accountable for ensuring that staff are knowledgeable in conjunction with collaborating and updating the department trainer for identifying gaps, refresher training and/or communicating any changes related to any of the lines of business.

Consistently supports the department by maintaining privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (if applicable), and CFHP policies and procedures. In addition, must be accountable for communication, implementation, enforcement, monitoring and oversight of compliance policies and practices to include the Health Insurance Portability and Accountability Act (HIPAA) related policies in regards to aspects of operations within Member Services.

EDUCATION/EXPERIENCE REQUIREMENTS

Bachelor’s degree is preferred. Two or more years’ experience working in a high volume inbound and outbound call center environment or 4+ years working in a call center position required. At least 2 years experience developing staff, multiple mainframe systems, ACD Phone Software, and using MS software are required (heavy experience with excel or access is strongly preferred). Ability to speak, read, and write in both English and Spanish is strongly preferred. Preferred Strong experience in call center supervision, training, and being able to develop “Best Practices” talent.

LICENSURE
Valid Texas driver’s license is required may need to travel to Community First other office location to assist as needed

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