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Assistant Manager, Medical Contact Center – (2500002U)
Job Purpose and Key responsibilities
Job Purpose:
- The job holder is responsible for managing Medical Contact Center for both Corporate Health and EMC departments by providing support and resolution to customer queries and complaints. This entails operational service delivery across all customer touchpoints including Medical Underwriting, Care, Provider Management and Claims sections as well as support the team leaders and managers in gap identification and make recommendations to improve on customer experience.
- The role is responsible for designing and implementing innovative initiatives to improve on Customer Satisfaction & Loyalty, business retention and formulation of strategies and actions plans for profitable growth through value-based cost control initiatives.
Key responsibilities:
- Manage relationships with clients, intermediaries, and service providers to ensure service level agreements are achieved and goodwill with stakeholders is maintained.
- Gathers statistical information and participates in internal and external audits; assists with the development and implementation of corrective action plans.
- Weekly business operations performance review to address gaps identified for continuous improvements and work with operation teams to implement these actions.
- Manage Medical Contact Center staff and resources, provide direction, set goals and ensure that round the clock coverage and accessibility is maintained.
- Formulate and maintain Medical Contact Centre metrics and processes for best-in-class experience.
- Oversee quality assurance of service incident data, emails, voice recordings, and customer surveys to identify areas of service delivery that did not meet pre-established performance standards.
- Liaises with business operations units and 3rd party service providers to ensure smooth running of outsourced Medical Business Operations including monitoring adherence to service level agreements.
- Support the Product Development team by identifying the customer needs and giving recommendations to product enhancements.
- Provide daily/weekly/monthly insightful metrics and reports that speak to operations and provision of service to medical functions and customers at large.
- Perform mock calls with new hires post-training to determine readiness for moving into frontline live environment.
- Tracking and management of pre-authorizations (outpatient, admissions, and discharges) requests to ensure efficiency and co-ordination of case management activities.
- Participate in control and oversee provider recruitment process.
- Develop and follow through on service improvement initiatives and processes for the Business from Customer feedback obtained from Medical Contact Centre to ensure service improvement.
- Lead and manage the staff at the Medical Contact Centre to ensure the existence of an environment where the team has high engagement, motivation and energy levels by being highly responsive to their concerns and needs.
- Developing suitable operational procedures to meet strategic objectives of the organization.
- Review documents and pertinent requirements regarding Customer experience operations.
- Respond to internal and external client inquiries and complaints across all touch points.
- Supervision, appraisal, training and development of Medical officers.
- Preparation of management reports for Corporate Health and EMC.
- Delegated Authority: As per the approved Delegated Authority Matrix.
Key Performance Measures:
- Customer Net Promoter Score (NPS).
- Customer Satisfaction (CSAT).
- Customer Effort Score (CES).
- Customer retention rate.
- Call and Email Service Levels.
- Medical Loss Ratio.
- Deviations on Quality Assurance Scores and SLA.
Knowledge, experience and qualifications required
- Bachelor’s’ degree in Nursing/any relevant degree.
- Professional qualification in Insurance (ACII , FLMI, or IIK) an added advantage.
- At least Six to Eight years’ experience in customer service environment.
- 2-3 years managing a Call Center.
- Medical Call Center is an added advantage.
- Excellent analytical and negotiation skills.
- Knowledge of insurance regulatory requirements.
- Knowledge of insurance products.
- Leadership and interpersonal skills.
Technical/ Functional competencies:
- Sales and marketing management skills.
