Supervisor, Grievance

a part of a team that transforms customer service into Customer Care by delivering an amazing experience.  As a leader at Convey you will focus on creating a culture dedicated to fostering an environment where compliance, quality and service excellence are your number one priority.  Lead a team of up to 10 dedicated professionals towards performance excellence across all metrics through daily coaching, mentoring and evaluations. Serve as a point of escalation for inquiries requiring advanced expertise in order to resolve complex customer issues and ensure timely follow up and customer satisfaction.  Must be comfortable operating in a fast paced, heavily regulated and high stress environment.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Supervise daily operations to guarantee success in meeting all CMS regulatory requirements, internal compliance, quality and operational metrics
• Daily review and communication of results with individual team members in an effort to engage and provide guidance to achieve performance excellence that is aligned with CMS guidelines, Client SLA’s and Convey standards
• Meet and/or exceed quality performance metrics through consistent quality monitoring and employee feedback
• Monitoring of productivity reports to ensure employee adherence to daily production expectations, quality standards in work product, and adherence to standard operating procedures for the department.
• Directly accountable for accuracy of employee ADP records, payroll approvals, PTO and scheduling
• Conduct coaching for QA while reviewing daily employee(s) performance and productivity.
• Coach and mentor team members and ensure quality feedback and continued development
• Establish mechanism for open communication and transparency with Grievance Manager and other department leadership which highlights areas of risk
• Support and communicate motivational campaigns for employees and achieve employee satisfaction
• Solicit feedback in open forums/huddles with employees and provide feedback to the Grievance Manager
• Escalate issues/risks that impact quality or performance relative to client expectations/SLA’s in an expedient manner
• Prepare corrective actions and performance improvement plans in accordance with the Human Resource policies and procedures. Administer approved documents to employee(s).
• Promote performance excellence by demonstrating integrity, dedication, magnanimity and accountability
• Must drive team results to meet key performance indicators including but not limited to 100% CMS timeliness, 90% or better QA scores, 90% or better compliance scores, Client SLAs and overall quality and accuracy of resolutions provided to customers.

EDUCATION & EXPERIENCE

• Bachelor’s or Associate’s Degree in related field from a four-year college or university or alternate “equivalency” of a combination of education and experience is sufficient.

• Number of years of leadership/supervisory/management experience (if any): 1-2

• Number of years of experience: 6-12 months successful experience in Grievance Analyst or above capacity working in a high volume Grievance department supporting Medicare Part D or Medicare Advantage plans.

About Us
Convey Health Solutions, together with Pareto Intelligence™, delivers a powerful combination of purpose-built technology, advanced analytics, and expert services to help health plans thrive in a complex, post--Affordable Care Act environment.

As a trusted partner to Medicare and commercial payers, we provide scalable, compliant solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment, Stars performance, and member engagement. Pareto's deep analytics and financial intelligence complement Convey's operational expertise, enabling our clients to improve performance, reduce costs, and create better healthcare experiences for millions of Americans--especially seniors and vulnerable populations.

Together, we help health plans scale smarter, grow stronger, and make healthcare work better for the people who need it most. Learn more at http://www.ConveyHealthSolutions.com