Job Description

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Provide comprehensive healthcare management to facilitate delivery of appropriate quality healthcare, promote cost effective outcomes and improve program/operational efficiency involving clinical issues.

Position Overview

The primary role is to meet the service level agreement of the process by coaching the CSRs/Nurse Associates to meet their monthly goals. They develop and mentor their direct reports to expand their capabilities and reach their full potential. They work with a team of Assistant Managers and Support staff to maintain effective team working relationships hence ensuring high level of engagement and morale in their respective teams.

• The Assistant Manager is responsible for management of CSRs/medical services staff including the organization and development of high performing teams
• Works closely with managers ensuring consistency in care management interventions
• Facilitates effective interfaces among team members, as well as across teams, providers and departments
• Responsible for the day-to-day implementation of medical management services policies and procedures
• Accountable for meeting the financial, operational and quality objectives of the unit

• Operational Efficiency

• Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance
• Assesses developmental needs and collaborates with the support team to identify and implement action plans that support the development of high performing teams
• Initiate root cause analysis and monitor action plans for identified opportunities
• Provide effective coaching and feedback to Nurse Associates that enable them to improve their performance
• Work closely with the Nurse Associates to identify areas for improvement and gaps in the process to create individualized and feasible action plans
• Monitor efficiency and initiate control measures to minimize variances in workload over time
• Executive monthly, quarterly, and annual performance review of Nurse Associates and consequent development processes effectively
• Ensures the team's understanding and use of information system capability and functionality
• Ensure implementation and monitoring of best practice approaches and innovations to better address the Case Manager and Utilization Management Nurse Consultant needs across the continuum of care
• Ensure compliance with internal policies and procedures, external regulations and information security standards
• Effectively forecast and manage the process volume, allocation, and staffing following the Statement of Work on a daily basis
• Maintain accurate reporting and cascading of information to internal and external stakeholders
• Update mandatory process trackers and files for compliance purposes
• Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
• Oversee and facilitate implementation of updates management and training for new hires and/or team members
• Lead calibration sessions to ensure process knowledge alignment
• Monitor random transactions on an ongoing basis and take corrective steps where necessary or make incremental improvements
• May have responsibility for their own case load work
• People Management

• Select staff using clearly defined requirements in terms of education, experience, technical and performance skills
• Formulate individualized plan with the CSRs/Nurse Associates to fully understand their career aspirations
• Develop a strong succession plan to encourage organic growth and facilitate "role ready" resources to ensures leadership continuity internally
• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed
• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
• Initiate engagement activities such as Monthly Townhall, Team building, and Internal group sessions to promote camaraderie within the department
• Lead change efforts while managing transitions within a team
• Accountable for maintaining compliance with Human Resource policies and procedures and implements them at the employee level
• Client Satisfaction

• Supervise the implementation of contact center management services
• Ensure business goals are met and compliance with policies and procedures is maintained
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Handle client feedback and escalations
• Promotes communication, both internally and externally to enhance effectiveness of medical management services
• Produce monthly or weekly dashboard/business reviews in partnership with support teams
• Client interaction such as touch base, business reviews, and calls where Assistant Manager involvement is required
• 1. Operational Efficiency (40%)

• a. Aggregate Productivity
• b. Aggregate Quality
• 2. People Management (40%)

• a. Aggregate Attrition (10%)
• b. ESAT (20%)
• c. Aggregate Team Absenteeism (10%)
• 3. AM Competency (20%)

• a. Coaching Compliance (10%)
• b. Admin Compliance (5%)
• c. Compliance (5%)

• Reports to:

• Lead Assistant Manager/Operations Manager/Senior Operations Manager

• Supervises:

• Executive and Senior Executives and Subject Matter Experts

• Collaborations to:

• Other Assistant Managers
• Lead Assistant Managers
• QCA/QC AM
• Process Trainer
• MIS and WFM
• Enabling Function Staff (HR Personnel, IBMS Staff, IT Resource, Clinic Staff)
• HCA Staff
• Stateside Counterparts

• Process owners
• Case Managers
• Supervisors/Team Leads
• Product Customer

• Providers from Doctor's Office and Facilities
• Representatives from Plan Sponsors
• Members

• 1. Position requires expertise with computer skills which includes navigating multiple systems and keyboarding
• 2. Computer literacy in order to navigate through internal/external computer systems, including Microsoft Office - Power Point, Word Document, One Note
• 3. Average working knowledge in Excel
• 4. Essential knowledge in internet usage and efficient email handling based on graded virtual simulation
• 5. Basic familiarity in use of projector, sound system and online-based training
• 6. Minimum of 40 wpm typing speed with 100% accuracy
• 7. Minimum of 80% Computer Proficiency, Logical Reasoning, and Handling & Interpreting Data
• 8. Competent Data Management
• 9. Requisite background in contact center management administration

• 1. Domain expertise is a must
• 2. Demonstration of profound familiarity and technical skill relevant to the process
• 3. Understanding and demonstrating the knowledge of end-to-end processes and appreciation of critical parameters
• 4. Able to identify with and comprehend data and new information
• 5. Planning and Organizing skills - ability to prioritize the tasks and deliver assigned task per deadlines
• 6. Execution of providing customer service
• 7. Must have experience in handling teams
• 8. Must have experience in handling escalations
• 9. Familiarity with basic medical terminology and concepts used in care management
• 10. Knowledge with US healthcare set up is a plus
• 11. Ability to effectively participate in a multi-disciplinary team including internal and external participants
• 12. Keen on details essential for clinical documentation
• 13. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

• Coaching and mentoring skills
• Above average presentation skills
• Listening and time management skills
• Self-disciplined and results oriented
• Strong motivation and willingness to step up and accept the challenge of the role
• Flexibility and urgency to handle pressure
• Ability to discharge the responsibilities in a conflicting environment
• Problem identification and analytical ability
• Ability to multi task
• Interpersonal Skills
• Customer Service Focus
• Team Work and Adaptability
• Ability to work with cross-cultural staff
• Management principles, human resources procedures, customer service and computer skills
• Verbal and written communication skills of at least B1 CEF level