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Team Leader Client Provider Services

Company: Excellus BlueCross BlueShield
Location: Rochester
Posted on: May 28, 2023

Job Description:

The Team Leader position will oversee staff responsible for researching complex claim problems, developing solutions for processing systems, and answering inquiries from members, groups, and providers in accordance with established MTM and divisional measures. This position will manage activities related to benefit and reimbursement audits, new group engagement, process improvement functions and track day-to-day Client Provider Services operations in support of the corporate strategies.
Essential Accountabilities:
--- Directs and manages the activities of the Client Provider Services staff including the management of workload as well as monitoring and tracking performance. Provides routine feedback on development, skills, and performance expectations.
--- Works directly with the Claims Payment Accuracy & Optimization leadership team to drive strategies and quality improvements. Share techniques and information with leadership to recommend and drive decisions and/or to improve Operation Excellence operations.
--- Identify and lead opportunities for improvement, facilitates problem solving sessions, acts as a catalyst for change and constantly sees opportunities to improve team's performance and group and provider satisfaction.
--- Manage the pre- and post-implementation audit, to ensure optimum service is provided to all customers while meeting accuracy, timeliness, and accessibility measures critical to quality transactions.
--- Works in coordination with the management of Sales to onboard new groups and gather detailed benefit requirements that will ensure the proper implementation of the group's benefits to the group's satisfaction.
--- Provides oversight of departmental projects in addition to day-to-day activities and participates in committees and work groups relevant to departmental processes. Prepares and delivers presentations to internal and external customers as requested.
--- Drives increased provider satisfaction, through communication, solution development, and issue resolution. Coordinates or attends regional or enterprise-wide provider seminars, focus groups, or communication sessions as needed.
--- Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
--- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
--- Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are compliant with these requirements.
--- Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
--- Regular and reliable attendance is expected and required.
--- Performs other functions as assigned by management.
Minimum Qualifications:
--- Nine (9) years of progressive experience within an operational setting or a Bachelor Degree in Business Administration, Health Care Administration, Statistics, Mathematics or Accounting and a minimum of three (3) years of experience in Customer Operations.
--- Experience in an operations setting, preferably with background in Customer Care or Provider Relations.
--- Prior experience supervising or managing people and/or projects or indirectly leading teams.
--- Demonstrated skills in leadership and conflict resolution.
--- Demonstrated skills in forming and fostering high performing, cross functional teams as well as establishing and maintaining effective relationships with other areas of the corporation.
--- Demonstrated knowledge and experience of health insurance industry and health insurance business, provider and member contracts, and operational policies.
--- Strong analytical and business process development skills and ability to identify and proactively respond to trends.
--- Communicates effectively with users/customers, across a range of disciplines in the Organization, and all levels of management.
--- Demonstrated competency in meeting or exceeding customer expectation.
--- Demonstrated ability to identify process improvement opportunities, has demonstrated knowledge of change management, and has instilled new process to standardized operations.
--- Proficient at identifying root causes of business and/or workflow problems and determining innovative solutions and opportunities
Physical Requirements:
--- Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time
--- Ability to work in a home office for continuous periods of time for business continuity.
--- Ability to travel across the Health Plan service region for meetings and/or trainings as needed.
One Mission. One Vision. One I.D.E.A. One you.
Together we can create a better I.D.E.A. for our communities.
At the Lifetime Healthcare Companies, we're on a mission to make our communities healthier, and we can't do it without you. We know diversity helps fuel our mission and that's why we approach our work from an I.D.E.A. mindset (Inclusion, Diversity, Equity, and Access). By activating our employees' experiences, skills, and perspectives, we take action toward greater health equity.
We aspire to reflect the communities we live in and serve, and strongly encourage people of color, LGBTQ+ people, people with disabilities, veterans, and other underrepresented groups to apply.
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation, and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Excellus BlueCross BlueShield, Rochester , Team Leader Client Provider Services, Hospitality & Tourism , Rochester, New York

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