Salary Range:  $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.)

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
 

Job Summary

The Lead Customer Solution Center Provider Service Representative is responsible for triaging, prioritizing, assigning and helping support PSRs in the high-performance of their position. The Lead is a "Working Lead" that is responsible for their own assigned inquiries and escalated cases, as appropriate. All Leads may provide support, coaching and feedback (excluding performance evaluations, as this is the responsibility of a Supervisor). Leads also play an important role in ensuring that the Provider Service Unit (PSU) completes its main goal  of a great customer service experience. 

Duties

Leadership and prioritization of day to day activities of Provider Service Representatives, including but not limited to: Assists in providing direction and instruction on case assignments; Handles all questions/issues raised by staff; Recommends process improvement processes; Prepares and analyzing call center statistical reports; Monitors/Adjusts of skill-sets for consistency; Ensures quantity/quality is met for overtime; Handles escalated calls; Acts as back-up to calls as needed; Assists Supervisor to ensure that Representatives provide accurate, timely and quality service to our members/providers. Ensure that all departmental policies, procedures and standards are being met, as well as the organization's mission; Assists Supervisor to ensure that performance opportunities are identified in advance and process changes are made to redirect performance to acceptable levels; Assists Supervisor to ensure that we provide accurate, timely and professionally written, statistical and verbal reports to management for historical, current status and forecasting purposes; Assists Supervisor in reviewing the Representatives overall quality accuracy; Ensures that front line service personnel are capturing information and providing feedback to Supervisors that will enable L.A. Care to improve its product and internal process; Represents the Department when requested at meetings; Assists Supervisor with meetings and provides necessary feedback when requested.

 

Assists with ongoing training and staff development to ensure appropriate service standards are developed and maintained. Works with training staff to ensure that training practices support staffing and performance standards, takes responsibility for identifying on-going training needs and integrating training and performance expectations as well as work closely with Supervisors to create and/or modify Desk top procedures.

 

Ensures department remains in compliant with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protected health information. (PHI).

 

Maintains attendance expectations.

 

Performs other duties as assigned.

Duties Continued Education Required Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred Bachelor's DegreeExperience

Required:
At least 0-2 years of customer service with 1 years experience in a health plan/health insurance customer service call center environment with 1 year of lead experience. 

 

Experience in working with the disadvantage population, Covered California, and Cal MediConnect. 

Skills

Required:
Must have knowledge in direct line of business.

 

Must know Medical Terminology. 

 

Must have excellent communication skills, strong analytical, coaching/mentoring skills, team building and the ability to work effectively with diverse team members. 

 

Must also have the ability to troubleshoot problem areas and recommend effective alternative solutions to handle irate callers, and provide optimal customer service for internal and external customers. 

Must be flexible with time and be able to work overtime including weekends. 

 

Must be able to multitask and to streamline day to day operations, policies and procedures. 

 

Must have advance PC skills including Excel and Access.

Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements LightAdditional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.

 

L.A. Care offers a wide range of benefits including

Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)