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Job Details

Member Services Team Lead - Public Plans

Company name
Tufts Health Plan

Location
Watertown, MA

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Profile

Under the general direction of Call Center Supervisor, is responsible for

* providing accurate and thorough interpretation of Tufts Health Plan (THP) benefits, claims processes, eligibility and enrollment policies to customers.

In addition to providing accurate technical information, the Team Lead, THPP Member Services Call Center is responsible for

* resolution of complex customer inquiries,

* the facilitation of problem resolution, and

* acting as a customer advocate by meeting or exceeding customers' expectations.

The Team Lead, THPP Member Services Call Center is expected to take personal and complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention, and satisfy corporate customer service goals and objectives.

The Team Lead, THPP Member Services Call Center plays an integral role in

* training and mentoring new and existing staff, conducting side by side sessions, call monitoring , etc.

* providing supervisor coverage in the absence of supervisor,

* handling of escalated calls and/or member walk-ins

* continuous queue monitoring

* Service Form audits

* special project assignments.

Additionally, the Team Lead, THPP Member Services Call Center has the intention of using this position as a stepping stone to career development, including toward the role of Supervisor.

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS* (in order of importance) % of TIME

(Optional)

Under the general direction of Call Center Supervisor, is responsible for

* providing accurate and thorough interpretation of Tufts Health Plan (THP) benefits, claims processes, eligibility and enrollment policies to customers.

In addition to providing accurate technical information, the Team Lead, THPP Member Services Call Center is responsible for

* resolution of complex customer inquiries,

* the facilitation of problem resolution, and

* acting as a customer advocate by meeting or exceeding customers' expectations.

The Team Lead, THPP Member Services Call Center is expected to take personal and complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention, and satisfy corporate customer service goals and objectives.

The Team Lead, THPP Member Services Call Center plays an integral role in

* training and mentoring new and existing staff, conducting side by side sessions, call monitoring , etc.

* providing supervisor coverage in the absence of supervisor,

* handling of escalated calls and/or member walk-ins

* continuous queue monitoring

* Service Form audits

* special project assignments.

Additionally, the Team Lead, THPP Member Services Call Center has the intention of using this position as a stepping stone to career development, including toward the role of Supervisor.

EDUCATION: (Minimum education & certifications required)

* Bachelor's degree preferred

EXPERIENCE: (Years of experience)

* Minimum of 2-3 years customer service and/or call center experience.

* Minimum of one year's experience as a THP Call Center representative.

* Prior experience managing project assignments

SKILL REQUIREMENTS: (Include interpersonal skills)

* Expert knowledge of Tufts Health Plan products and services, including knowledge of key operations departments, their functions and a familiarity with professional relations, medical management and marketing services is required.

* Must have the ability to appropriately identify emergency situations and follow the appropriate protocol.

* Must be knowledgeable of resources available within the organization to resolve both internal and external problems and concerns.

* Requires excellent verbal and written communication skills.

* Requires the ability to work in a complex environment.

* Must be able to exercise excellent judgment and be effective working autonomously.

* Strong information management skills including the ability to organize information, identify subtle and/or complex product and service delivery issues that impact customers and the ability to articulate and pursue solutions to problems impacting service.

* Must be able to work cooperatively as part of a team.

* Requires strong interpersonal skills and an ability to provide excellent customer service in order to promote a positive company image.

* Must be able to effectively communicate with internal and external customers in verbal and written format.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)

* Fast paced environment handling multiple demands.

* Must be able to exercise appropriate judgment as necessary.

* Requires the ability to balance multiple priorities and function in a complex, rapidly changing environment.

* Requires a high level of initiative and decision-making skills.

* Must anticipate, defuse, and redirect potentially problematic situations.

* An open cubical environment with a Personal Computer and telephone.

* Occasional evening, weekend, or extended workdays may be required.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Company info

Tufts Health Plan
Website : http://www.tufts-health.com/

Company Profile

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