Manager, Provider Operations - Provider Call Center Liaison
Hawaii Medical Service Association
- Honolulu, HI
- $73,154-121,252 per year
- Permanent
- Full-time
- Bachelor's degree and five years of related work experience; or equivalent combination of education and work experience.
- Two years of supervisory, management, or leadership experience.
- Understanding of claims processing and reimbursement.
- Excellent verbal and written communication skills.
- Demonstrated project and process management skills.
- Basic knowledge of Microsoft Office applications including Word, PowerPoint, Excel, and Outlook.
- Direct and oversee all aspects of the Provider Call Center, in alignment with corporate goals and initiatives. Manages, oversees, and evaluates staff.
- Ensure Provider Call Center performance meets/exceeds Key Performance Indicators by evaluating, analyzing, and interpreting data and metrics. Report on or supervise reporting of KPI metrics.
- Ensure cross-functional collaboration and partnerships are developed and maintained in support of functional alignment.
- Lead, manage, or direct and coordinate projects that directly impact the Provider Call Center.
- Collect, analyze, and utilize data and feedback to identify opportunities to improve the relationship between the business and HMSA's provider network.
- Contribute to the ongoing design, development, and implementation of key core systems utilized by the Provider Call Center.
- Effectively work with vendor and HMSA staff to resolve claim issues/inquiries accurately at first contact from stakeholders. Maintain ongoing audit program to ensure quality.
- Respond to provider escalations received via the Provider Call Center as needed.
- Perform all other miscellaneous responsibilities and duties as assigned or directed.