BH UM Call Center Manager

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

The position will directly support the Behavioral Health UM Director in overseeing all BH UM call center operations. The primary responsibility will be to provide adequate oversight and structure, as well as establish and implement effective initiatives to enhance the customer experience resulting in member/provider satisfaction, retention and growth. The Manager’s focus will be on effectively meeting, sustaining and exceeding departmental goals and metrics related to high quality service and exceptional performance. The position will collaborate with the BH UM Director to coordinate strategic and result driven goals, implement them and follow through to improve the BH UM department performance, for both CORE and HARP lines of business.

• Attend/represent BH UM Department in all required internal/external Behavioral Health meetings.
• Assess service statistics and implement strategies to improve quality of service and productivity for the BH UM team.
• Work with BH Departmental Team Lead Supervisors to set and communicate performance standards that are specific and measurable, and in support of them business’ mission.
• Create effective BH UM procedures, policies, and standards with focus on meeting all regulatory requirements, enhancing provider and customer experience.
• Contribute to improve provider and member experience by identifying opportunities and solutions and sharing ideas and best practices with others.
• Work closely with the internal partners across the Health Plan and vendors to maintain operational processes and collaborate on UM workflow initiatives.
• Plan, prioritize and delegate work tasks to ensure proper functioning of the department and ensure timely completion.
• Develop, maintain, and strengthen collaborative partnerships with others inside or outside the organization who can provide information, assistance, and support.
• Liaise with company management to support and implement growth strategies
• Identify and address staffing needs and coordinate training and coaching.
• Supports BH UM Director in fostering a culture of excellence, growth and accountability.
• Assists with being compliant with regulatory agency guidelines and standards; prepares and completes action plans
• Other duties as assigned by the BH UM Director.

• Bachelor’s degree in Business Administration or relevant field.
• A minimum of 5 years’ proven supervisory experience in a customer service.
• At least 1-2 years working in Behavioral Health, Managed Care or Hospital
• Training in product lines of business and medical management; specifically, UM clinical operations expertise supporting front line UM team members.
• Proficiency in Microsoft Office and customer service software.
• Outstanding written and verbal communication skills.
• Good understanding of leadership management practices and techniques.
• Excellent interpersonal skills.

Professional Competencies

• Transparency
• Integrity and Trust.
• Critical Thinker
• Communications Skills
• Interpersonal Awareness
• Process improvement
• Managing Change