Manager, Customer Service

San Francisco Health Plan (SFHP) is actively looking for a Manager, Customer Service. Reporting to the Senior Manager, Member Services, the Customer Service Manager is responsible for the management of staff and daily operations of the Customer Service Department according to industry and SFHP standards. You will oversee the daily Customer Service tasks to ensure compliance with regulatory requirements, and they will work closely with other departments to complete cross functional assigned projects, resolve problems, and identify areas for improvement.WHAT YOU WILL DOManage Customer Service staff providing exemplary customer service in all areas of service and ensures member rights are protected and SFHP policies are followed.Maximize staff performance on efficiency and productivity including the availability of staff on the phone. Oversee tasks and projects, ensuring they are completed timely and accurately.Work with Workforce Manager to monitor phone traffic and Automated Call Distribution (ACD) wall boards consistently. React immediately to unexpected high call volume by finding resolutions to reduce the impact to Customer Service phone metrics. Regularly monitor phone calls for quality assurance and provides feedback to staff.Work with Workforce Manager to analyze call activities, trends, and patterns. Create and implement action plan for improvement.Train, coach, motivate, and update staff. Provide positive/negative feedback to staff and takes disciplinary actions if needed.Provide guidance on staff development, staff performance management, and any other staffing or personnel related issues that may arise on the team. This includes identifying training opportunities both for knowledge gaps, as well as upskilling.Ensure metrics and goals of both SFHP and the department are achieved.Recruit quality employees for Customer Service and updates job descriptions.Ensure all Customer Service owned grievance related functions and member billing assistance inquiries are handled timely and properly according to regulatory requirements and deadlines. Attend grievance review committee meeting.Ensure that confidentiality of member information is maintained, and that staff is in compliance with HIPAA regulations.Oversee updates to SFHP policies and procedures and desk-top procedures pertaining to the Customer Service Department. Evaluate, streamline, and redesign processes. Implement new procedures in the operational process when needed in collaboration with the Customer Service Trainers.Represent Customer Service Department and provide internal and external presentations as required.Work closely with other departments on cross functional projects (EPG) and provides timely updates. Detect and diagnose issues and collaborate with other departments to resolve problems.Enhance Customer Service operations continuously by contributing information and recommendations for strategic planning and reviews, implements productivity, quality, and customer-service standards.Identify customer service trends and determine system improvements.Create SMART goals for multi- level employees for yearly performance evaluations.Prepares budget and manages expenses for Customer Service Department.Lead and assist the Customer Service department through NCQA, DHCS and DMHC audits. This may also include internal audits performed by the Compliance and Regulatory Affairs Team. Completes and oversees any resulting corrective actions.Provide timely updates to the Senior Manager of Member Services.Promote and further SFHP’s culture and mission by fostering an environment where all staff are recognized, understood, appreciated and embrace inclusion and belonging.WHAT YOU WILL BRINGBA/BS degree or equivalent combination of education and work experience.Minimum of four years of experience in staff supervision in a call center environment.Four or more years of experience in managed health care.Extensive experience in management, budgeting, training, motivating, and coaching.Experience in handling grievances.Experience in creating policies and procedures.Excellent skills in customer service and project management.Expertise in planning and problem solving.Extensive knowledge of SFHP health programs and Medi-Cal managed care. Thorough understanding of the grievance process.Thorough understanding of an ACD (or similar) system.Superior communication skills.Proficiency in QNXT is preferred, especially in member related functions and claims.WHAT WE OFFERA competitive and robust compensation package, including:Health benefitsMedical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the HMO plans is currently available at no cost and dependent coverage is heavily subsidized by SFHP.Dental: You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.Vision: Employee vision care coverage is available through Vision Service Plan (VSP).Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 PlanTime off – 23 days of Paid Time Off (PTO) and 13 paid holidaysProfessional development: Opportunities for tuition reimbursement, professional license/membership.An opportunity to work in a vibrant atmosphere with the most amazingly talented people who are shaping the future of healthcare!The chance to make a difference in the lives of many San Francisco residents!ABOUT SFHP:Established in 1997, San Francisco Health Plan (SFHP) is an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.San Francisco Health Plan is an E-Verify participating employer.Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.

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