SUPR, Member Services Call Center

Central Coast Salary Range: $84,877 - 123,072

​​​​​​​Candidates for this position must reside on the Central Coast (Ventura, Santa Barbara, San Luis Obispo, Monterey and Santa Cruz Counties) or be willing to relocate to the area upon hire. As a community-facing role, a local presence is essential to effectively engage with and serve our community. Please note that relocation assistance may be available.

Job Summary
Expectations of this position are to ensure that CenCal Health’s Call Center staff within a queue environment meets or exceeds all objectives and goals relating to Call Center Service Level Metrics and Standards as established by regulatory, contractual requirements, Department Director, and Quality Committees as appropriate.  This position also provides for the daily oversight and supervision of the Member Services Representatives, hiring, mentoring, evaluations, terminations including appropriate staffing and supervisor coverage for the telephone queue.  This position will ensure service to CenCal Health’s membership and its provider network that is aligned with the Plan’s strategic goals and mission statement. In this role, the Supervisor will provide guidance regarding complex issues requiring an in-depth knowledge of all CenCal Health programs and benefits.  The incumbent must be a positive team member contributing to the successful and cohesive unit.

Duties and Responsibilities

The Call Center Supervisor is a role model for the Leads, Senior and Member Service Representatives (MSRs) in helping them build their skill set while supervising their daily activities ensuring that the Department workload is completed in a timely manner and meets established goals for service and quality standards related to established metrics. This position must demonstrate a thorough understanding of CenCal’s various healthcare program benefits and any applicable co-payments, eligibility, dual and OHC coordination of benefits, coordination with the local government and Community Based Organizations (CBO) agencies, pharmacy formulary, and provider network workings which include but are not limited to the following:

• Primary role in the hiring and termination of Call Center staff

• Responsible for the coordination with the Member Services Trainer for training and in-servicing needs and oversight of new and established Call Center staff

• Monitor and evaluate 6-month introductory performances and annual reviews to ensure continuous performance of the Call Center Team based upon established goals and assignments

• Establish and maintain effective working relations with the Call Center Team by establishing weekly meetings to discuss any issues and or provide updated information. 

• Establish and maintain monthly one on ones with Call Center Team to discuss monthly metrics, provide positive feedback and or coaching if needed.

• Monitor calls and perform PCP audits handled by the MSR’s, based upon established goals and assignments, in collaboration with the Call Center Manager, Call Center Supervisors, and Member Services Trainer

• Provide guidance to the Sr. and line staff requests for assistance as appropriate in responding to escalated member issues, difficult calls or situations as prescribed by the Call Center Manager and/or Director

• Work with Call Center Manager and Sr. to ensure a continuously improving workflow process, identify needs and make recommendations to   Director

• Identify and make recommendations regarding policies/procedures and assist the Associate Director and MS Trainer in updating applicable department policy and procedures as they relate to the Call Center

• Identification and resolution of Health Information System programming issues or need for improvements related to the Eligibility, PCP Selection Screen, COG and various screens used by the Call Center staff

• Establish and maintain effective and coope