University of Utah Health Care

  • Manager, Health Plans Customer Service

    Requisition Number
    35488
    Reg/Temp
    Regular
    Employment Type
    Full-Time
    Shift
    Day
    Work Schedule
    8am - 6pm
    Location Name
    University of Utah Health Plans
    Patient Care?
    No
    City
    Murray
    State
    UT
    Department
    UIP CST 01H UUHP OPERATIONS
    Category
    Customer Service
  • Overview

    As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

    The University of Utah Health Plans Customer Service team provides world class service to our members and providers by demonstrating empathy, advocacy, and expertise. This team answers inquiries while optimizing efficiency, service, and quality. This team seeks to optimize the member and provider experience by offering one call resolution by being experts in benefits, eligibility, and claims processing.

    The overall objective is to maintain and exceed performance expectations by continuing to improve the member and provider experience, implementing strategies to manage staffing needs and attrition, collaborating with various internal and external stakeholders, documenting policies and procedures to complete objectives.

    This position is responsible for managing the day-to-day operations related to customer service. This position monitors claims volume, staffing needs, and ensures performance expectations are met as it relates to the quality of customer service, service levels, tools and resources, and fostering a positive team environment.

    Department Overview: University of Utah Health Plans (UUHP) was formed in 1998 as a strategic initiative of University of Utah Health Care. We are committed to the "triple aim" of improving experience and quality of care, improving the health of populations, and reducing the per capita cost of care. We currently serve over 140,000 members specializing in the health plan administration of medical, mental health and pharmacy benefits for self-funded employer groups, commercial programs, as well as, government programs including Medicare and Medicaid. We are leaders in health care transformation. We recognize the importance of population health and payment reform and have developed extensive care management and value-based payment programs that improve health and align provider reimbursement with value and positive outcomes. Being integrated with University of Utah Hospitals & Clinics and the University of Utah Medical Group (physicians), we are uniquely positioned to bring greater value, better cost efficiency and an increased patient focus to our members and clients.

    Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our four hospitals and seventeen clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

    This position is not responsible for providing care to patients.

    Responsibilities

    Accountability
    • Accountable to meet the customer service performance expectations of the organization.
    • Manage turn-around time for offering resolution of questions and appeals to claim decisions.
    • Resolves escalated issues arising from operations requiring coordination with other departments.
    Collaboration
    • Forms positive associations with staff, peers, and senior leadership to support the mission, vision, values and performance standards of the organization.
    Communication
    • Proactively engages with all internal and external business partners to achieve plan goals and organization objectives.
    • Ability to translate strategy into clear, concise and actionable initiatives and action plans.
    • Engages with employees in an open, respectful manner having crucial accountability conversations when needed.
    Technical Development
    • Develops and maintains strategies consistent with evolving national programs, methodologies and technologies.
    • Analyzes data to identify and recommend new processes, procedures and improvements.
    Financial Management
    • Develops, monitors, and achieves budget goals within assigned areas of direct operational leadership.
    • Manages labor and non-labor budgets to ensure efficient use of resources.
    Quality
    • Offers and implements solutions to increase efficiency, service, and quality.
    • Manages and promotes continuous process improvements in assigned area of direct operational leadership.
    • Identifies and recommends strategies to streamline and improve operational efficiencies within the Service Delivery Area.
    Performance Management
    • Supervises assigned personnel and provides feedback on performance, including on-time appraisals and coaching, when appropriate.
    • Manages and resolves any business and/or professional conflicts in a proactive manner and to reach resolutions in a timely manner.
    • Engages with staff in developing talent, career path planning, and improving staff morale and employee engagement.
    Relationships and Engagement
    • Creates positive and productive team environment.
    • Actively engages staff with updates and news as well as involving staff in decisions and work teams.
    • Upholds PROMISE standards in all internal and external interactions.

    Knowledge / Skills / Abilities

    • Demonstrated potential ability to perform the essential functions as outlined above.
    • Demonstrated human relations and effective communication skills.
    • Knowledge of and experience with Medicaid, Marketplace, and Medicare insurance programs preferred.
    • Ability to work effectively, independently, and as part of a team.
    • Ability to supervise and communicate effectively with staff, management and executives.
    • Strong organization, time management and project management skills and multi-tasking abilities.
    • Detail oriented with problem-solving abilities.
    • Ability to work within the Workforce Management platform.
    • Ability to use online chat as a customer service tool.

    Qualifications

    Qualifications

    Required

    • Bachelor's degree in a related area, or equivalency.
    • Four years of progressively more responsible management experience with a track record for results oriented performance in health insurance operations environment.
    • Experience with a Workforce Management platform.
    • Experience with online chat as a customer service tool.

    Qualifications (Preferred)

    Preferred

    • Master's degree in Business Administration, Health Care Administration or a related area.

    Working Conditions and Physical Demands

    Employee must be able to meet the following requirements with or without an accommodation.

    • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions

    Physical Requirements

    Color Determination, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Reaching, Sitting, Speaking, Standing, Walking

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