Supervisor

• Dec 2018 - Present

Customer Service Supervisor

• Jun 2018 - Dec 2018

Supervisor

• Jan 2015 - Sep 2017

o Oversee the day-to-day activities of Member Service Representatives including, but not limited to: monitoring daily production, scheduling, time and attendance, appropriate coverage, and equipment functioning and availabilities, etc. o Schedule and manage the inbound customer service center, optimize productivity by monitoring member service agent statistics and taking appropriate action to ensure agent schedules accurately cover call volumes and minimize down time.o Assist members in finding community resources. Document member specific assessments, education and outreach efforts in the member service system.o Review and respond to email and phone messages from staff and management. Assist member service representatives with difficult customers, taking those calls when necessary. o Train, develop, motivate and assist team members in reaching new levels of skill, knowledge and understanding.o Coordinate and complete staff meetings to communicate to all colleagues any developments or information necessary for them to fulfill their responsibilities. Participate in management and senior management meetings as scheduled to maintain strategic alignment with branch and company business objectives.

Managed Care Coordinator

• 2013 - 2015

o Initiate non-clinical outreach and initial assessment activities to members.o Document in software system member-specific assessments, education and outreach efforts.o Coordinate health-related services to improve member access to care and care plan in conjunction with the case/disease manager.o Assist members in finding community resources. o Observe confidentiality of member records in accordance with HIPAA guidelines and company policies.o Maintain a professional level of telephone etiquette and manners.

Grievance Coordinator

• 2010 - 2013

o Compose and mail written communication to members and/or providers in compliance within AHCCCS and CMS grievance time frames.o Communicate with organizations (regulatory agencies, contracted providers, etc.) and members to request and submit information as appropriate.o Accurately and efficiently track and trend all grievances received ensuring resolution within regulatory time frames.o Effectively work with health plan staff from other departments to solicit information in order to resolve grievance issues and receive, investigate and document member grievances. Retrieve daily complaints from the CMS Complaint Tracking Module (CTM), the health plans communication system and department email box accurately each business day.o Facilitate the resolution of member problems while acting in accordance with plan policies and guidelines.o Conduct member and provider outreach as part of each grievance investigation to obtain information for resolution.