Coordinator, Customer Services Position Available In Allegheny, Pennsylvania

Coordinator, Customer Services 3.4 3.4 out of 5 stars Pittsburgh, PA 15222 UPMC Community Care Behavioral Health is hiring a Coordinator of Customer Services. This position will manage customer service staff within the department. This position will work Monday – Friday 12:30 pm – 9 pm. Candidates may reside anywhere within Pennsylvania. This role is based in a dynamic, high-volume Behavioral Health (BH) triage call center, responsible for receiving inbound calls from both members and providers. The department handles emotionally intense and high-acuity situations, including conducting initial crisis triage assessments. Holidays are required, as the CCBH Member Services Department is a 24/7 office. There is a volunteer process, but otherwise, holidays are assigned, as needed. The Coordinator of Customer Services has overall responsibility for managing daily operations for the unit. This individual is responsible for the administrative supervision and management of the specified customer services teams. The Coordinator ensures provision of customer services consistent with all applicable policies and procedures. The Coordinator represents the organization to providers, member groups and families, and participates in overall operations management as warranted. Despite the pay range listed, the current budget for this position is $31.89/hr – $38/hr.

Responsibilities:

Assumes daily responsibility for the education & referral activities provided to Community Care members and providers through the customer services department. Measure procedures effectiveness focusing on the improvement of service for member/providers; make recommendations for procedure improvements; implement changes as needed; set up a process for maintain reporting on procedures. Participates in CQI activities and provider training, and participates in professional development activities. Provides accurate information concerning benefits and coverage to staff or other persons as required. Complete special projects and performs related duties as assigned. May engage in the acquisition or transfer of structured clinical data, but does not engage in any activities that involve clinical evaluation or interpretation. Monitors daily activity to ensure that services of the department are provided within NCQA, URAC and DHS, and other internal and external standards. Coordinates the complaint and grievance process for members and providers. Maintains an up-to-date understanding of benefits, in-plan and supplementary services, and the regulatory environment and remains current on covered benefits, limitations, exclusions, and policies and procedures and the specifics of all contracts. Orients, trains, and oversees Customer Services staff; and conducts performance reviews as required by organizational policies. Participates in making presentations to participating providers, state and federal agencies, community groups and other interested parties. Acts with the authority of the Manager of Customer Services when designated. Utilizes supervision effectively. Reports call center and data entry issues to Manager of Customer Services. Identifies member and provider issues and recommendations for improvement. Works with Network Management and Quality Management staff to assure that systematic revisions to improve services are developed and implemented. Responsible for directly assisting daily operations of the Customer Services department when scheduled staff are unable to perform their duties. Works with internal network staff and providers to identify areas for the development of additional services to best meet members’ needs and access standards. Receives and responds to complex calls and assists Customer Services staff to resolve complex issues. Meets with members and families, primary care and behavioral health providers, and other agency staff as needed to develop and coordinate member and provider educational opportunities. Provides oversight of the teams providing education, benefit information, and referral assistance to all Community Care members and providers. Coordinates, reviews and maintains data for reporting purposes and for preparation and analysis of trending reports as needed. Works closely with the manager in the continued development of the customer services department. Actively participant on the call center management team; driving success for the call center. Bachelor’s or Associate’s degree with related experience and/or equivalent work experience. Five years of customer services and/or call center experience required. Call Center experience is highly preferred. Experience with Workforce Management is highly preferred. Experience in behavioral health and/or managed care strongly preferred Supervisory experience managing 24 hour operation strongly preferred Strong leadership skills and abilities; strong, independent decision-making ability is a must. Experience in training and coaching staff required. Knowledge of managed care functional areas, including terms and definitions, required Strong writing and computer skills Complete and thorough understanding of Excellence in Service requirements

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran