Team Leader Behavioral Health QC/ALA

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.Appointment scheduling/Financial recovery/order Management/ Patient Experience Services.

Job title:Team Leader Behavioral Health QC/ALA

Job Description:

DUTIES & RESPONSIBILITIES:

Shift Management Function:

Performs daily monitoring of CSAs quality & productivity metrics by utilizing reports and database available.

Implements floor management policies in order to ensure adherence to service level agreements between clients.

Ensures that CSAs scheduled for the day is accounted for.

Ensures connectivity and proper functioning of systems/ equipment of the CSAs prior to the shift and reports to workforce, CT group and Operations Manager for the immediate repair/ replacement of defective unit.

Answers questions while CSAs are on-line and provide assistance in cases of technical problems experienced by CSAs in their function.

Ensures that coaching and huddle schedules on a daily basis are carried out.

Ensures CSAs adherence to schedules – shift schedule and off the phone schedules.

Ensures that Team Leader checklist is completed daily and submitted weekly to his/ her respective leader.

Escalates issues to Operations Manager or Shift Manager.

Accomplish monitoring requirements as needed.

Quality & Policies/Procedures Compliance Monitoring Function:

Be able to provide timely and accurate updates to the CSAs thru scheduled coaching time and/ or ad hoc for Hotline behaviors and/or non-compliance errors.

Be able to carry out process related activities within the prescribed turn-around time.

Ensures that non-compliance errors are coached to CSAs within the turnaround time.

Ensures that all monitored calls are reviewed within the turnaround time.

Attends calibrations and alignment meetings with support groups (QA and/ or Training).

Knows and follows existing internal and external processes of the program

Be able to carry out disciplinary action documents on a timely manner.

Ensures that CSAs adhere to work schedule.

Staff Development/Team Building Function:

Be able to manage and resolve CSAs’ HR related concerns

Be able to ensure high morale of the team by carrying out team bonding activities.

Be able to coach CSAs and provide feedback on weekly performance as evidenced by a signed coaching log. Complete one-on-one feedback sessions with CSAs, which can include counseling for disciplinary purposes (Ensure high motivation with low disciplinary actions).

Be able to cascade process/ product updates to CSA on a timely manner

Be able to do trend/ call handling analysis on CSA’s calls for coaching and action planning.

Be able to create specific Individual Development Plans for CSAs over a given period of time.

Be able to effectively cascade internal & client-related policies and programs to CSAs on a timely manner.

Be able to meet with team at least once a week to discuss issues and share best practices.

Be able to identify team members who display potential for other positions within the company. Assign tasks or projects to further develop that potential.

Administrative Function:

Generates individual semi-monthly Employee Attendance Records via Global ESS.

Reflects approved changes on schedules.

Be able to conduct yearly performance appraisals.

Be able to investigate and validate violations to the Project Cigna Code of Conduct, recommends and serves corresponding disciplinary action.

Be able to perform special assignments or handle projects as delegated by leaders.

Be able to submit reports as needed:

Weekly Coaching logs

Weekly Huddle Agenda

Weekly & Monthly Team Performance Reviews

Yearly Performance Appraisal for each CSA

IDPs for CSAs

Monthly EXCEED Nominees

Others:

Perform tasks assigned by the Shift Manager.

Periodically conducts interviews and screening for agent positions.

General Safety and Security

Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS).

Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.

Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act & URAC.

COMPETENCY REQUIREMENTS:

With Moderate Competency Level in the ff.:

US Healthcare Delivery System Philippine Healthcare Delivery System Communication Skills (Spoken) Communications Skills (Written) Customer Service Orientation Computer Literacy Job Knowledge Sense of Urgency Passion for Excellence Working in Team/Interpersonal Skills Work Organization People Management/Team Orientation Drive for Results/Execution Thriving in Change Expertise/Analytical Skills Product Knowledge Problem Solving Presentation Skills Facilitation Skills Coaching Process Improvement Performance Management Discipline Management

OTHER REQUIREMENTS:

Reports to:

Shift Manager

Supervises:

Customer Service Associates (CSA)

Education and/or Experience:

Preferably, an Active Philippines Certified Registered Nurse (RN) with 1-2 years clinical experience;

Or a graduate of any 4-yr College Degree and/or equivalent with 2 – 3 years of customer service experience.

Language Skills:

English, additional language a plus. Strong communication and interpersonal skills.

Computer skills:

MS Office

Certificates, Licenses, Registrations:

Preferably, with an Active Philippines Certified Registered Nurse (RN) license.

Work environment:

The work environment is professional, office. Business casual attire.

Physical demands:

May require weekend, evening or shifting work schedule.

Work Demands:

Able to establish, implement and continuously improve the quality information security policies assigned to him / her.

Able to establish structures and procedures to protect classified information.

Able to report information security related incidents without any delay to the proper authorities.

Example: All information-related incidents, losses, weaknesses and software/hardware malfunctions, breaches of confidentiality.

Able to participate during training, orientation and awareness programs pertaining to QISMS.

DUTIES & RESPONSIBILITIES:

Shift Management Function:

Performs daily monitoring of CSAs quality & productivity metrics by utilizing reports and database available.

Implements floor management policies in order to ensure adherence to service level agreements between clients.

Ensures that CSAs scheduled for the day is accounted for.

Ensures connectivity and proper functioning of systems/ equipment of the CSAs prior to the shift and reports to workforce, CT group and Operations Manager for the immediate repair/ replacement of defective unit.

Answers questions while CSAs are on-line and provide assistance in cases of technical problems experienced by CSAs in their function.

Ensures that coaching and huddle schedules on a daily basis are carried out.

Ensures CSAs adherence to schedules – shift schedule and off the phone schedules.

Ensures that Team Leader checklist is completed daily and submitted weekly to his/ her respective leader.

Escalates issues to Operations Manager or Shift Manager.

Accomplish monitoring requirements as needed.

Quality & Policies/Procedures Compliance Monitoring Function:

Be able to provide timely and accurate updates to the CSAs thru scheduled coaching time and/ or ad hoc for Hotline behaviors and/or non-compliance errors.

Be able to carry out process related activities within the prescribed turn-around time.

Ensures that non-compliance errors are coached to CSAs within the turnaround time.

Ensures that all monitored calls are reviewed within the turnaround time.

Attends calibrations and alignment meetings with support groups (QA and/ or Training).

Knows and follows existing internal and external processes of the program

Be able to carry out disciplinary action documents on a timely manner.

Ensures that CSAs adhere to work schedule.

Staff Development/Team Building Function:

Be able to manage and resolve CSAs’ HR related concerns

Be able to ensure high morale of the team by carrying out team bonding activities.

Be able to coach CSAs and provide feedback on weekly performance as evidenced by a signed coaching log. Complete one-on-one feedback sessions with CSAs, which can include counseling for disciplinary purposes (Ensure high motivation with low disciplinary actions).

Be able to cascade process/ product updates to CSA on a timely manner

Be able to do trend/ call handling analysis on CSA’s calls for coaching and action planning.

Be able to create specific Individual Development Plans for CSAs over a given period of time.

Be able to effectively cascade internal & client-related policies and programs to CSAs on a timely manner.

Be able to meet with team at least once a week to discuss issues and share best practices.

Be able to identify team members who display potential for other positions within the company. Assign tasks or projects to further develop that potential.

Administrative Function:

Generates individual semi-monthly Employee Attendance Records via Global ESS.

Reflects approved changes on schedules.

Be able to conduct yearly performance appraisals.

Be able to investigate and validate violations to the Project Cigna Code of Conduct, recommends and serves corresponding disciplinary action.

Be able to perform special assignments or handle projects as delegated by leaders.

Be able to submit reports as needed:

Weekly Coaching logs

Weekly Huddle Agenda

Weekly & Monthly Team Performance Reviews

Yearly Performance Appraisal for each CSA

IDPs for CSAs

Monthly EXCEED Nominees

Others:

Perform tasks assigned by the Shift Manager.

Periodically conducts interviews and screening for agent positions.

General Safety and Security

Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS).

Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions.

Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act & URAC.

COMPETENCY REQUIREMENTS:

With Moderate Competency Level in the ff.:

US Healthcare Delivery System Philippine Healthcare Delivery System Communication Skills (Spoken) Communications Skills (Written) Customer Service Orientation Computer Literacy Job Knowledge Sense of Urgency Passion for Excellence Working in Team/Interpersonal Skills Work Organization People Management/Team Orientation Drive for Results/Execution Thriving in Change Expertise/Analytical Skills Product Knowledge Problem Solving Presentation Skills Facilitation Skills Coaching Process Improvement Performance Management Discipline Management

OTHER REQUIREMENTS:

Reports to:

Shift Manager

Supervises:

Customer Service Associates (CSA)

Education and/or Experience:

Preferably, an Active Philippines Certified Registered Nurse (RN) with 1-2 years clinical experience;

Or a graduate of any 4-yr College Degree and/or equivalent with 2 – 3 years of customer service experience.

Language Skills:

English, additional language a plus. Strong communication and interpersonal skills.

Computer skills:

MS Office

Certificates, Licenses, Registrations:

Preferably, with an Active Philippines Certified Registered Nurse (RN) license.

Work environment:

The work environment is professional, office. Business casual attire.

Physical demands:

May require weekend, evening or shifting work schedule.

Work Demands:

Able to establish, implement and continuously improve the quality information security policies assigned to him / her.

Able to establish structures and procedures to protect classified information.

Able to report information security related incidents without any delay to the proper authorities.

Example: All information-related incidents, losses, weaknesses and software/hardware malfunctions, breaches of confidentiality.

Able to participate during training, orientation and awareness programs pertaining to QISMS.

Location:Alabang, Plaza E BuildingPhilippines

REQ-006779