Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY:
Experienced in a Health Care / Plan Customer Service Center professional. Individual should possess extensive knowledge of health insurance. Experience in working on projects; assisting staff, ad hoc support to other areas as needed. Exhibits leadership qualities.
Customer Service Supervisor:


The Customer Service Center Supervisor will provide direct oversight of the Customer Service Center Representatives as they answer questions and handle complaints of customers to ensure that department performance requirements are met. They will coordinate with the Customer Service Center Coaches to develop and foster a highly effective team, ensuring that established goals and standards are met, manages daily workload to uphold productivity levels, quality outcomes, performance guarantees, timeliness, and customer satisfaction metrics. Works with other departments to address complex issues for an appropriate resolution. Assist in process improvement initiatives.

MINIMUM QUALIFICATIONS:
1. Education/Specialized Training/Licensure:  H.S. Diploma  Associates degree preferred.
2. Work Experience (Years and Area):  Three years of experience with health insurance, managed care, or other related experience required.  Preferred knowledge of Contact Center operations.
3. Management Experience (Years and Area): Experience in working on projects; assisting other reps, ad hoc support to other areas as needed is required.
Exhibits leadership qualities.  Preferred knowledge of Contact Center operations.
4. Software Proficiencies:  Microsoft Word/Excel/PowerPoint required.
 

Application Instructions

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