Resp & Qualifications
PURPOSE: Directs and provides oversight to Brokers Service to ensure that inquiries related to account installation, enrollment, billing and claims, etc. are handled timely, efficiently and with high quality. Monitors section performance to ensure that all expectations are met while containing costs to meet financial goals and ensuring compliance with standards and guidelines. Recommends, coordinates and directs solutions to improve operations and broker service, working cross-functionally throughout the organization. Distributing and monitoring Department e-mail and RightFax requests sent electronically from Full Service, General Producer Platinum Producers and Broker Community. Maintains running reports from Business Objects to insure turnaround times established for Broker Support remain in compliance with corporate guidelines. Develop and maintain cost center budget, coach and train staff, monitor daily operations and work flow. Provide direction, assistance and guidance, define goals and objectives to optimize staff’s ability to deliver service to customers and motivate staff toward goal attainment. The incumbent is challenged by continually changing environment, regulations and problem-solving issues affecting service. Acts as liaison between Broker Sales, internal and external customers by attending meetings to develop procedures, enhance systems and resolve problem situations.
Under the general supervision of the Sr. Director Broker Services, the Director’s accountabilities include, but are not limited to, the following:
1. Directs and leads daily activities of a large Operations area of business. Maintains a high level of member, broker, and account satisfaction by leading associates responsible for handling inquiries from group administrators, brokers, attorneys and/or inquiries addressed to Senior Executive Staff. Responsible for all aspects of the section’s operation, including service to accounts, claims adjustment and clerical workflows. Ensures that staff receives training, guidance, direction, support, and development, to obtain targeted results. Ensures that a consistent, high quality, timely and cost-effective level of service is provided, and that all internal and external goals and objectives are met.
2. Coordinates cross-functionally with a wide range of areas to meet customer needs, implement projects, addresses service/processing issues, improves quality of service, and implements useful and improved technology. Represents the Operational area on a wide range of corporate initiatives. Coordinates and develops policies, as well as the relationships, between the areas managed and other departments of the corporation (such as Sales, Medical Affairs, Systems Analysis and Planning, Network Management, Contract Compliance, Legal, etc.) in order to:
• facilitate the exchange of information,
• provide competitive analysis and product planning,
• aid strategic initiatives,
• ensure customer, broker service issues are taken into consideration
• ensure intradepartmental initiatives are effectively coordinated and implemented
• achieve results
Ensures compliance of the areas managed with all regulatory requirements, mandates, policies and other requirements. Provides substantial day-to-day support for internal areas.
Reviews and analyzes data, reports, survey results, complaints, appeals data and performance information to strategically determine allocation of staff and to consistently meet or exceed performance expectations. Develops strategies and executes detailed action plans to ensure excellent results and continuous improvement of broker service operation
3. Maintains regular contact with and is accountable for group administrators’ and Broker satisfaction. Responsible for the resolution of highly complex and sensitive account/member/broker issues. Maintains direct customer contact; personally handles the most complex and difficult inquiries and situations. Prepares and delivers formal presentations, conducts account/broker visits, interacts on a face-to-face basis with current and prospective accounts.
4. Responsible for associate development including Supervisor skills building. Creates, approves and discusses all performance plans and reviews for associates. Ensures adequate training, associate development and support. Identifies performance issues and develops plans to improve that performance. Uses action plans and career path tools where applicable. Ensures staff adheres to all policies, procedures and processes. Responsible for a positive and productive work environment and provides ongoing reinforcement and identification and resolution of problems. Hires and terminates employment; handles corrective action. Meets with staff at least bi-weekly.
5. Directs the preparation and management of the section’s budget and allocation of resources.
Direct reports include but are not limited to: Manager(s), Supervisors, Project Manager and/or clerical staff. Provides oversight of approximately 45 + indirect reports and 4+ direct reports.
Required: Bachelor’s Degree or equivalent work experience. At least eight years of progressive management or supervisory experience in a customer service, claims or enrollment and billing related discipline. Health Insurance and Call Center Experience, including knowledge of state-of-the-art technology.
Abilities/Skills: Proven ability to manage a large section and multiple responsibilities. Exceptional oral and written communication skills. Customer-focused and results-oriented. Strong analytical/problem-solving abilities. Extremely well-organized. Demonstrated ability to achieve results under pressure. Strong interpersonal and team building skills. Innovative, flexible leader.
Must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Preferred: Bachelor’s Degree in health care administration or Business Administration Preferred.
Department: Small Medium Broker Service Management
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Hire Range Disclaimer
Actual salary will be based on relevant job experience and work history.
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Please apply before: 11/9/2018
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
The physical demands described here are representative of those that must be met by an associate to perform the essential duties and responsibilities of the position successfully. Requirements may be modified to accommodate individuals with disabilities.
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The employee must frequently talk and hear. Weights of up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship