Providence Supervisor, Behavioral Health-Service Operations in Beaverton, Oregon
Providence St. Joseph Health is calling a Supervisor, Behavioral Health-Service Operations to our location in Beaverton, OR.
We are seeking a Supervisor, Behavioral Health-Service Operations who will lead a professional team of dedicated Customer Care Coordinators responsible for servicing Member and to a lesser degree, Provider telephone, chat and email inquiries for all lines of business and customers with Behavioral Health & Substance Use Disorder benefits. Must possess a well-rounded and diverse level of Medical Benefit/Product expertise including one or more of the following: Medicare & Medicaid, Commercial (Full Risk), Individual Direct & Marketplace, and Administrative Services Only (ASO/Self-funded). Demonstrated and working knowledge of Behavioral Health principles, policies and benefits in addition to a strong background in direct support or leadership roles related to Quality Improvement initiatives, resolution of claims and enrollment issues, and rapid identification of customer service production and resource issues related to resource and staffing deficiencies.
In addition, the Supervisor should possess a strong working knowledge of applicable Medical & Behavioral Health/Substance Use Disorder Regulatory requirements regarding accurate and timely claims processing, State, Federal and Regulatory inquiry response times, member enrollment and materials distribution, member status change transactions, group and individual premium billing, premium reconciliation, and delinquency and collection processes. This critical, front-line leader must foster effective working relationships with the Health Care Services "HUB", vendors, consultants and other PHP staff in performing their duties. Performs a key leadership role in providing an industry-best Customer Experience in a supportive, team-based environment.
In this position you will have the following responsibilities:
Telephone average speed of answer (ASA) and % of calls answered within agreed upon SLAs and applicable contractual requirements. This includes CMS and OHP specific requirements related to Medical/Physical and any applicable Behavioral Health specific metrics.
Established departmental and shared and/or dependent Call Quality measurements with HCS partners.
Ensure chat and Email response times meet internal and external best-practices, SLAs and applicable contractual requirements including CMS and OHP.
Behavioral Health and Substance Use Disorder specific staff mentoring, development and training support including Implicit Bias and Crisis.
Attrition rate maintenance and reduction.
Lead and support a Dedicated, "HUB" based Customer Service Operations responsible for Behavioral Health and Substance Use Disorder inquiries, issue resolution, Navigator support and cross-functional teams.
Supervise coordination of all work, quality improvement activities, projects, objectives, and staffing of the department by working with direct manager.
Evaluate performance and initiate personnel actions such as talent acquisition, annual increases, probationary and periodic reviews, promotions, transfers between teams, and other tasks in concert with Human Resources as needed.
Foster professional, working relationships with peers, leaders and all other Providence Health Plan (PHP) staff as needed.
Provide a supportive, TEAM-based environment that facilitates group decision making and employee empowerment.
Collaborate with PHP staff with product development initiatives, benefit changes, various system upgrades/conversions/implementations, while serving as champion for a positive member experience.
Create, maintain and foster collaborative relationship with Workforce Management Analyst (WFMA) to ensure all scheduling, forecasting and contact center requirements are met on a daily and ongoing basis. If applicable and as needed, serve as backup to WFMA.
Required qualifications for this position include:
Bachelor's Degree in Business Management, Healthcare Administration, Accounting, or related field, plus 4 years management/industry experience OR;
Associate's Degree with 6 years related management/industry experience or 8 years related management/industry experience including but not limited to Behavioral Health MCO, clinical, social service, or facility based experience.
4 years Customer Service background in managed care environment with 2 or more product lines.
Demonstrated experience with PM methods, Agile concepts and leading cross-functional teams of Operations and IT staff members.
Preferred qualifications for this position include:
- 1 year demonstrated experience in navigating Behavioral Health benefits and policies.
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Req ID: 272818