Customer Service Training and Quality Improvement Manager

Salary Range: $83,243 - $124,864
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.

FLSA Status: Exempt

Department: Customer Services

Reports To: Manager, Customer Service Quality and Training Program

GENERAL DESCRIPTION OF POSITION

The Customer Service Training and Quality Improvement Manager is responsible for developing training resources, providing training to the Customer Service department and delegates in according with NCQA, regulatory requirements and SCFHP policies and procedures, and service level objectives. The position routinely conducts quality reviews, identifies trends, and incorporates findings into existing and new trainings to improve performance in a manner that maintains compliance with Medicare and Medi-Cal regulatory requirements and achieves Call Center service-level objectives.

ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily.

1. Develop and maintain a thorough understanding of SCFHP processes and workflows to inform training needs.
2. Develop maintain and implement Customer Service training materials and update desktop resources and processes to meet regulatory and accreditation requirements, to meet or exceed call center service level objectives, and to improve the call center staff call navigation and handling experience.
3. Constantly adjust training curriculum to address changes to benefits, networks, delegated relationships, programs, and to address needs and improve resources of call center staff.
4. Conduct frequent call quality reviews and provide timely coaching and feedback in accordance with Customer Service (CS) Quality Monitoring Program (QMP). Prepare and maintain up-to-date quality scorecards and reports and Facilitate call quality/calibration reviews internally with Call Center staff and externally with Health Plan's delegate(s).
5. Identify issues and trends through call auditing and make recommendations to Call Center management for process improvements.
6. Provide training to member-facing SCFHP staff outside of customer service and delegated entities as needed.
7. Serve as a CS Helpdesk point of contact to assist new hires and newly trained Customer Service Representatives (CSRs) with questions or issues to ensure that timely and appropriate responses are given.
8. Conduct NCQA required assessments. Prepare data and complete quantitative and qualitative reports to ensure NCQA requirements are met. Conduct root-cause analysis and based on findings, share and provide feedback to CS Management or applicable workgroup.
9. Participate in Call Center telephone quality performance by answering a limited number of inbound calls each month involving SCFHP program services and benefits to gain real-life experience with the call handling process, and deepen the understanding of the call center staff's day to day work.
10. Participate in Customer Service team meetings, quality calibration sessions, and other internal or cross-functional meetings as necessary to understand company-wide and departmental objectives, Customer Service departmental needs, and to keep abreast of work process changes affecting the Call Center.
11. Perform any other related duties as required or assigned.

REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

1. Associate's Degree in Healthcare or a related field, training, coursework or equivalent experience. (R)
2. Bachelor's Degree in Health Care administration or a related field, training or coursework. (D)
3. Minimum three years of experience working with managed care, Medi-Cal or Medicare program, with significant exposure to training individuals and groups. (R)
4. Excellent communication skills including the ability to express oneself clearly and concisely when providing training to SCFHP internal departments and outside entities over the telephone, in person or in writing. (R)
5. Ability to conduct internal quality reviews, auditing and/or training. (R)
6. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
7. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
8. Ability to maintain confidentiality. (R)
9. Ability to comply with SCFHP's policies and procedures. (R)
10. Strong knowledge of Call Center management best practices. (R)
11. Strong interpersonal skills with the ability to collaborate with others and work as a team.
12. Ability to create well organized, accurate, and concise material and work documentation for training, QMP evaluations, scoring, and coaching sessions. (R)
13. Working knowledge of and ability to efficiently operate applicable computer software such as Microsoft Outlook, Word, Excel, PowerPoint, Visio and SharePoint. (R)
14. Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the Customer Service Department operations as dictated by business needs. (R)
15. Bilingual - Spanish or Vietnamese. (D)
16. Ability to perform the job safely with respect to others, to property, and to individual safety. (R)

WORKING CONDITIONS
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors in person, by telephone and via work-related electronic communications.

PHYSICAL REQUIREMENTS
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation.

1. Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies; and sit or stand for extended periods of time. (R)
2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds. (R)
3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less. (R)
4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment. (R)
5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone. (R)
6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person, by telephone, and electronically throughout a typical workday; attention to detail. (R)

ENVIRONMENTAL CONDITIONS

General office conditions. May be exposed to moderate noise levels.

EOE