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Job Grade: 22

JOB SUMMARY:

Responsible for the planning, development, and implementation activities in support of DSU Claims, Call Center and Telesales operations. Responsible for organizing and leading a team of Medicare telesales, retention, regional consultants, quality and operational analysts to meet Medicare product membership, quality, and productivity goals. Interfaces with Corporate and health plan leadership to develop operational strategy and institute actions, workflows, key performance metrics, and procedures to achieve efficient and effective processes between the DSU, home office business units, and health plan operations. Supports process changes linked to technology initiatives, quality, audit, and risk management initiatives for call center operations.

PRIMARY RESPONSIBILITIES:

Process & Quality Improvement:
1. Develops operational processes, procedures, policies, process maps, and initiatives in accordance with the goals of AMERIGROUP'S mission, vision and values, the needs of the health plans, and federal and state regulatory requirements.
2. Oversees Process Change Management Committee focused on process changes submitted by the health plans and/or other corporate departments, as assigned.
3. Serves as a liaison to the Account Management team and is held accountable for all DSU customer service initiative processes.
4. Provides direction with regards to process and quality controls in the DSU.
5. Responsible for process changes that cross functional areas and establishes proper handoffs and controls to effectively provide a balance between clinical and non-clinical processes within the DSU.
6. Attends key meetings and forums as the organization's representative.
7. Evaluates core operating competencies of the department regularly to ensure adherence to policy and risk mitigation activities are occurring.
8. Engage proper resources to facilitate root cause analysis and identification of process or training deficiencies.
9. Serves as process owner/project lead to execute key tasks in the DSU's Quality, Process Improvement & Telesales Business Plan.

Telesales:
10. Plan, organize, and manage all telesales call center activities for assigned team, including organization, monitoring, reporting, performance management, and staffing.
11. Possess strong interpersonal skills to manage, develop, and retain staff.
12. Direct activities of telesales team to meet or exceed sales and productivity goals.
13. Establish and monitor sales and productivity goals to include training, monthly performance tracking, and daily review of productivity metrics.
14. Ensure highest level of customer service and strict adherence to CMS regulations through regular monitoring and coaching.
15. Ensure the quality and accuracy of data in the contact management system through the development and use of audit reports, quality monitoring, and regular feedback.
16. Provide initial sales training to new hires and regular updates, supplemental training for the re-education of staff. Topics to include product designs, market specifics, technical (phone/system) changes.

17. Develop and submit timely and accurate reports to measure the effectiveness of marketing campaigns, individual performance of representatives and the cost/value relationships of individual marketing efforts.
18. Maintain a current knowledge of developments in Medicare regulatory compliance. Take responsibility for the compliance of telesales team practices and procedures to include the tracking and execution of non-resident licensing.
19. Works with plan Sales and Marketing Directors to review productivity, leads and to coordinate ... To view the rest of this job posting or to apply for this position please click the APPLY NOW button

Job Benefits