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The Lead Support Center representative manages complex member and provider issues while providing technical expertise and escalations support. They also mentor new staff and ensure high-quality service delivery across multiple communication channels.
Mon - Fri 11:30am - 8pm EST Hours (Must be flexable to work on weekends due to buisness needs)
JOB DESCRIPTION Job Summary
Provides lead level support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, identifies opportunities to improve the member and provider experience, and supports continuous quality improvement initiatives related to member/provider engagement and retention.
Essential Job Duties
• Manages and resolves complex member/provider support center issues; effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow-through to closure.
• Collaborates with peers, leadership, and other departments to resolve member/provider issues in an effective and timely manner.
• Provides technical expertise to co-workers and handles elevated escalations; provides service support to members and/or providers using one or more support center communication channels serving multiple states and/or products including but not limited to: phone, chat and email, in addition to other administrative off phone duties supporting Medicaid, Medicare and/or Marketplace lines of business.
• Provides exemplary customer service to customers including members, providers, co-workers, vendors, providers, government agencies, business partners, and the general public.
• Assists representatives with questions and escalated support center communication channels across multiple states and/or products; recognizes trends and patterns in call types and engages leadership with suggested solutions.
• Accurately documents all support center communication channels.
• Achieves individual performance goals as it relates to support center objectives.
• Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
• Provides training, mentoring, and support to new and existing support center representatives.
Required Qualifications
• At least 4 years of customer service, call center and/or sales experience in a fast-paced/high-volume environment, or equivalent combination of relevant education and experience.
• Understanding of insurance products including Medicaid, Medicare and Marketplace/enrollment processes.
• Customer service skills, including ability to conduct thorough research while maintaining coherent conversation with customers.
• Data processing experience.
• Attention to detail, organizational and time-management skills, and ability to manage simultaneous tasks to meet business needs.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.
Preferred Qualifications
• Systems training/experience for the following : Microsoft Office, Microsoft Teams, Genesys, Salesforce, Pega, QNXT, CRM, Verint, video conferencing, CVS Caremark, Availity.
• Call center experience.
• Managed care/health care experience.
• Broker/health insurance license.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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