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Kaiser Permanente Careers

Customer Service

Making Each Interaction Extraordinary

Functioning as a liaison between our members, employer groups, providers, brokers, and internal customers, our customer service groups are the face and voice of Kaiser Permanente. They play a vital role in explaining our offerings, policies, and procedures as well as meeting the needs of our members across the country.

Team Manager, KPIF Membership Administration-On Exchange

Location: San Diego, CA Additional Locations:
Job Number: 792661 Date posted: 05/02/2019
Description:

Performs planning and direction setting. Manages customer Administrative Representatives and/or billing or enrollment representatives. Handles personnel issues with a team approach. Ensures that service standards are achieved. Acts as a member/client advocate. Jointly responsible for the daily operations in order to develop and maintain a superior membership service experience center. Lead the business processes. Ensure best practice customer service and/or membership administration while maximizing revenue. Responsible for the implementation of operational and technology best practices to improve compliance capabilities and efficiencies. Establishes and assures adherence to budgets, schedules, work plans and performance requirements in compliance with department performance guarantees of over 12 million dollars. Responsible for maintaining robust and effective relationships with group customers and stakeholders to further promote KP strategy. Actively promotes the vision and values of the CSC Operations organization -- particularly in the areas of customer service, change management, leadership, performance levels, optimization and results orientated.



Essential Responsibilities:

  • Business Acumen - 30%

  • Performs financial management, tracking, analysis and resolution of accounts receivables to ensure financial goals for the line of business are met.

  • Learns core book of business functions and understand guidelines, policy and procedures.

  • Understands how work is received and processed within the membership systems.

  • Recommends changes in guidelines, procedures, processes, policies to improve departmental performance and to comply with regulatory changes in Healthcare Administration.

  • Ensures compliance with regulatory agencies and compliance with financial requirements such as SOX.

  • Provides operational direction to team and resolves operational issues while navigating ambiguity and time constraints

  • Business Acumen - 30% (Continued)

  • Collaborate with business partners to analyze processes, develop & implement improvement activities of line of business strategies.

  • Gathers resources to ensure timely and accurate resolution of accounts receivable and alignment of operational goals. Identifies and implements line of business strategies to align processes, determine gaps in performance and drive results toward achievement of long term strategic goals.

  • Responsible for using operational data and metrics to drive business decisions related to workforce management and inventory, turnaround time and productivity.

  • People Management - 50%:

  • Manages the day to day operations of a line of business and responsible for the administration of KP customers membership, enrollment or billing services to customers of the health plan. Oversees and directs the work of the staff to maintain high quality of work with revenue enhancement and customer service focus by monitoring line of business performance. To include prioritization of work to ensure that SLA's are met.

  • Responsible for capacity planning and staffing for their team.

  • Manages a team of administrative and senior administrative representatives. Attracts, selects and maintains a qualified, motivated staff which involves interviewing, coaching, counseling, disciplining, advising, monitoring, training, and terminating within a union environment. Report team performance and improvement plans to business leadership. Mentors staff for success in current role and development of skills and abilities to support succession planning.

  • People Management - 50% (Continued):

  • Develops schedules to assure adequate staffing levels to support regional business needs. Assigns and monitors work for timely and accurate processing of customer eligibility and premium payments reconciliation to ensure billing and payment of health insurance premiums.

  • Measures and monitors service performance quality standards to ensure customer satisfaction.

  • Analyzes and monitors data and reports to improve employee and departmental performance.

  • Collaboration - 20%

  • Represents the Health Plan within the local community on line of business benefits and service matters.

  • Collaborates with Sales and Account management and Benefits, Contracts and Government Program divisions of KP to interpret contract language and handle line of business concerns. Ensures the timely intervention of group member issues to enhance customer satisfaction, customer recruitment/retention.

  • Partners with KP departments, sales & marketing, customers and other stakeholders as well as external business partners, consultants, auditors and third-party administrators.

  • Basic Qualifications:

    Experience

  • Minimum four (4) years directly related experience in a health care, financial services or high-volume transactional operations role.

  • Minimum two (2) or more years supervisory or management experience in a health care, financial services or high-volume transactional operations role.

  • Education

  • Bachelor's degree in business administration, health care, finance, accounting or related field or four (4) years of experience in a directly related field OR an associate's degree AND two (2) years of experience in a directly related field.

  • High School Diploma or General Education Development (GED) required.

  • License, Certification, Registration

  • N/A



  • Additional Requirements:

  • Requires knowledge of membership management and working knowledge of another functional area.

  • Knowledge of labor contracts and HR/Organization/Department policies and procedures.

  • Strong interpersonal and communication skills; excellent written and verbal skills.



  • Preferred Qualifications:

  • Experience establishing and achieving compliance, quality, production and productivity targets preferred.

  • Have experience with operational processing, tracking and monitoring work and financial management preferred.

  • Experience de-escalating and resolving complex customer issues preferred.

  • Experience in a Labor/Management partnership or similar environment strongly preferred.

  • Experience using mainframe or personal computer database, word processing, and statistical analysis software packages preferred.
  • Primary Location: California,San Diego,California Service Center 3840 Murphy Canyon Rd. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:00 AM Working Hours End: 5:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Manager with Direct Reports Job Category: Customer Services Department: KPIF Membership Administration - On Exchange Travel: Yes, 10 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    About Customer Service Careers

    Customer Service Careers

    With over 11 million members, more than 127,000 employees, and over 40 million doctor visits a year, our customer service teams need you to come work with a wide variety of people to address concerns, resolve grievances, and educate our communities about our offerings. At Kaiser Permanente, you'll put your communication and mediation skills to work in support of excellence. We are committed to supporting you with ongoing growth, training, and development opportunities.

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