Medicaid Call Center Team Lead II

Medicaid Call Center Team Lead II

Lead II – BPM

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are:

UST HealthProof is looking for a Medicaid Call Center Team Lead II, reporting to the Operations Manager or as designated by the Director of Operations for Healthcare Platform Solutions. The primary objective of the Call Center Team Lead II is to implement policies and procedures to foster an environment of excellence in servicing UST HealthProof Healthcare Customers. This includes leading and managing a team of 12-15 Call Center agents, examiners, adjusters, extensive interaction with client organization and multiple stakeholders, delivering a high-quality Call Center operation meeting and exceeding all service level agreements and KPIs, driving operational excellence and building competencies for delivery.

The Opportunity:

• Be responsible for directly managing a staff of 15-20 associates.
• Be responsible for day-to-day interaction with client organization to help run a high-quality Call Center operation.
• Collaborate with the client in creating Call Center reports (inventory, production, productivity, priority and forecasting) to meet and exceed all production Service Level Agreements (SLA).
• Collaborate with client and Audit team to understand and establish a robust Quality program – to measure, analyze, root cause analysis and take and take Corrective Actions as needed.
• Ensure setting smart goals for teams and provide regular feedback, appraisal and coaching to ensure performance.
• Be responsible for managing personnel matters like attendance, holidays, PTO, sick days, approve hours for payroll, shift timings etc. with the prime objective of meeting and exceeding customer deliverables.
• Collaborate with Subject Matter Experts (SMEs) to ensure that Standard Operating Procedures (SOPs) are adequate for the needs of the operations teams, review them periodically for updates and enhancements and ensure version control and client approvals.
• Conduct call listening and assess the call based on quality forms provided.
• Ensure that information provided during the call done by the agents are accurate.
• Timely and accurate completion of standard and advanced quality forms, reports and analysis.
• Complete ad hoc reports as requested.
• Attend and participate in quality calibration session.
• Provide immediate education, report error trends and propose action plans to mitigate errors, as needed.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need:

• 5-7+ years of Healthcare operations experience, out of which 2+ years in supervisory role.
• Must have some background in administration and preferably some experience in healthcare including but not limited to medical coding, transcription, doctor’s office, billing, account receivable on Call Center processing experience preferred.
• Some experience in outsourcing operations or service industry preferred.
• High proficiency in using MS Excel and PowerPoint.
• Good understanding and ability to analyze Call Center data and report, SLA, KPI, operations report and present findings in a structured way.
• Excellent People skill – ability to build and motivate a large operations team of up-to 20 associates.
• Some ability to train and guide the teams thru changes in processes and operating instruction.
• The ability to adapt quickly to a fast-paced environment.
• Ability to coach the team to reach their full potential.
• Ability to gel with the team well and build a self-organized and highly energetic team.
• High priority bilingual in Spanish – Requires a flexibility to schedule worked up to and including 8am to 9pm eastern standard time, 7 days a week depending on client seasonality.

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $45,000 – $60,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

• Simplicity

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

• Integrity

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

• People-Centricity

Everything that we do reflects our deep bonds with peers and customers. These aren’t mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

• Leadership

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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