Lead, Customer Experience - Member Services (Remote)

Ideal Candidate will have Leadership, customer service and Medicaid experience.

• Must be available to work between operation hours of 5:00am-8:00pm PST.
• Bilingual Preferred

Job Summary

Provides customer support and stellar service to meet the needs of our Molina members and providers.

Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions.

Provides product and service information, and identifies opportunities to improve our member and provider experiences.

Knowledge/Skills/Abilities

• Provide technical expertise to co-workers and handles elevated calls.
• Proficient in two lines of business or more (e.g., Medicaid, Marketplace, Medicare).
• Accurate documentation for all calls across multiple platforms.
• Responsible for owning, handling and resolving complex issues.
• Consistently exceeding individual performance goals established for the position in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.
• Evaluate risk criteria and determine urgency and appropriate escalation path.
• Manages multiple channels of communication (e.g., Teams, Jabber) within a timely manner.
• Proficient in Microsoft Office applications (e.g., Excel, Word, PowerPoint).
• Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner.
• Recognizes trends and patterns in call types and engages leadership with suggested solutions.
• Effective communication skills in a professionally setting, both spoken and verbal.
• Familiarity with Provider Service inquiries related to: Claims, Authorizations, Appeals, Contracting and Credentialing.
• Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
• Assists with training needs of employees or training classes as needed along with providing coaching/feedback and mentoring agents.
• Familiarity with processes related to Claim Adjustments and Adjudication.
• Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public.

Lead by the Molina Values

• Supportive Teamwork: Eagerly assist your co-workers
• Integrity Always: Set a good example by continuously Doing the Right Thing.
• Member and Community Focused: Act as an advocate on behalf of our callers
• Honest and Open Communication: Be true to your word
• Absolute Accountability: Take responsibility for ensuring escalated calls are handled with excellent service.

Preferred Systems Training

• CVS Caremark
• Salesforce
• Microsoft Teams
• Genesys
• Video Conferencing
• CRM
• QNXT
• Verint
• Genesys
• Pega
• Kronos
• Microsoft Office Professional (Excel, PowerPoint, Word).

Job Qualifications

REQUIRED EDUCATION:

Associate’s Degree or equivalent combination of education and experience

Required Experience

5-7 years

Preferred Education

Bachelor’s Degree or equivalent combination of education and experience

Preferred Experience

7-9 years

Physical Demands

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office or home office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Pay Range: $18.85 - $36.77 an hour*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.