Manager of Contact Center Operations

A Healthcare Service Organization is seeking a Manager of Contact Operations. The Manager of Contact Center Operations is responsible for leading the contact center team in a healthcare environment, ensuring high-quality service delivery while maintaining compliance. This role involves managing teams, optimizing processes, leveraging technology, and ensuring adherence to regulatory and contractual service-level agreements (SLAs).

Responsibilities:

• Oversee daily operations of the contact center
• Monitor call volumes, service levels, and KPIs (e.g., Average Speed of Answer, Abandonment Rate, Handle Times).
• Develop and implement strategies to improve customer experience and operational efficiency.
• Develop policies for claims processing, fraud prevention, data privacy, and compliance adherence across departments.
• Lead and coach supervisors, team leads, and agents to ensure high performance.
• Develop training programs focused on healthcare compliance, claims processing, and customer service excellence.
• Maintain quality assurance programs to ensure adherence to healthcare regulations and TPA service agreements.
• Develop strategies to enhance member and agency satisfaction while reducing complaint resolution times.
• Oversee escalations and work with payer clients, agency, and internal teams to resolve complex issues.
• Work with IT teams to enhance CRM, IVR, and analytics tools for operational efficiency.
• Develop and present compliance and performance reports to senior leadership and payer clients.
• Monitor KPIs such as Call Resolution Rates, Claims Inquiry Turnaround, CSAT, and Compliance Metrics.

Qualifications & Skills:

• Bachelor's degree in Healthcare Administration, Business, or a related field.
• 5+ years of experience in managing a contact or call center
• Deep understanding of claims processing, eligibility verification, prior authorizations, and appeals..
• Experience with contact center technologies (CRM, ACD, IVR, analytics tools, and AI solutions).
• Proven ability to lead teams in a high-volume, highly regulated environment.
• Strong analytical, problem-solving, and decision-making skills.
• Excellent stakeholder management skills, including experience working with payers, providers, and regulatory bodies..

Preferred Skills:

• Healthcare or TPA industry experience
• Familiarity with process improvement methodologies (Six Sigma, Lean, or similar)

Compensation: $85,000-$110,000
Salary is based on a range of factors that include relevant experience, knowledge, skills, other job-related qualifications.