AVP, Medicare Call Center Operations (REMOTE)

Job Description

Job Overview... The Associate Vice President of Call Center Operations plays a critical role in managing and optimizing call center operations, with a focus on supporting Medicare-related services. As an AVP, you'll lead a team responsible for delivering exceptional customer service to Medicare beneficiaries Responsibilities: Strategic Leadership • Develop and execute strategies to enhance call center performance, ensuring efficient handling of Medicare inquiries, claims, and member services. • Collaborate with cross-functional teams to align call center operations with Medicare compliance and quality standards. Operational Excellence • Oversee day-to-day call center activities, including call volume management, workforce planning, and performance metrics. • Implement best practices to improve efficiency, accuracy, and member satisfaction. • Responsible for ensuring teams deliver effective customer service for all service needs including benefits, claims, billing inquiries, service requests, suggestions, and complaints. • Directly and through team members resolves both member and provider inquiries and complaints fairly and effectively. • Provides direction and coordination to deliver accurate product and service information to members and providers and identifies opportunities to increase membership by improving our member and provider experience. • Recommends and implements programs to support member and provider needs. Works within a matrix environment with dotted line relationships across multiple lines of business. • Ensure leaders and staff are working on retention and expansion initiatives. • Ensure compliance with Medicare guidelines and regulations. • Drives and maintains relationships with all contact center vendors to drive performance excellence. Provides leadership and oversight of all call center vendors, including ensuring all outsourced call center vendors meet all key performance indicators and contractual requirements. Quality Assurance • Monitor call center interactions to maintain high-quality service. • Implement quality control processes and provide feedback to agents. • Address escalated issues promptly. Technology and Process Improvement: • Evaluate call center technologies and tools to enhance productivity and member experience. • Identify process bottlenecks and recommend improvements. Stakeholder Collaboration: • Work closely with Medicare program managers, compliance officers, and other relevant stakeholders. • Provide regular updates on call center performance and initiatives. Job Qualifications Education: Bachelor's degree (advanced degrees preferred). 10 years of experience: • Proven leadership experience in healthcare operations, preferably call center operations within the Medicare and MMP domain. Experience preferred with dual eligible (Medicare-Medicaid) population. • Familiarity with Medicare regulations, policies, and procedures. • Strong analytical skills and ability to drive process improvements. • Excellent communication and collaboration skills. • Previous experience managing staff, including hiring, training, managing workload and performance. • Experience in managing a large-scale call center with remote staffing preferred. • Experience in improving CTM performance and impact, as well as driving Customer Satisfaction (NPS) Improvement. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Apply Job!