Henry Ford Health System Supervisor, Call Center Provider Inquiry - Health Alliance Plan in Detroit, Michigan

Primary Objective:

To supervise, organize and coordinate the Provider Inquiry Call Center. To maximize service levels through scheduling, floor management, coaching and performance management. To maintain and report on all information related to the provider’s inquiries received via the telephone/lobby and/or fax. Review, triage, and facilitate all information related to the Provider inquiries, complaints, or grievances received throughout the HAP systems.

Duties and Responsibilities:

  • Supervise, develop, coordinate and control all workflow activities in the Provider Inquiry Department (which includes phone monitoring, scheduling staff & adjudicating the phone queue assignment schedule, based on trends to maximize the efficiency of the call center productivity).

  • Determine training, policies, procedures and benefit needs related to customer servicing.

  • Maintain quality control within Provider Inquiry based on Provide inquiry--- feedback via letters, phone, e-mail via HAP’s website, provider survey cards, and quality audits performed by the department Quality Auditors.

  • Evaluate employee performance, initiate appropriate coaching and developing and implement disciplinary action within area of responsibility.

  • Develop the Call Center Statistical Analysis Reports on a daily/monthly/annual basis, including developing all associated written policies and procedures.

  • Monitor the quality and quantity of the communication between the Client Service Specialists and customers received by telephone and/or in person.

  • Focus on continuous improvement on customer service and the development of staff in a customer oriented way.

  • Interface with the Customer Services Correspondence and Grievance sections to be involved in the integral part of resolution for member complaints/grievances received by HAP.

  • Develop processes/measures that will ensure staff receives continuing education on most current benefits, products, policies, procedures, systems tools, in cooperation with the departmental Training Coordinator.

  • Assist and/or handle provider complaints received through the President’s Office, Board of Directors, Media, Insurance Bureau, or the Department of Public Health ensuring a focus of customer satisfaction in complaint resolution.

  • Coordinate with internal support departments, i.e., Marketing, Membership & Billing, Claims and Finance Divisions, in the resolutions of enrollment related problems.

  • Perform other related duties as assigned.

Education & Experience Required:

  • Bachelor’s degree in Health Care, Business or related field

  • Minimum of three (3) years of experience in a health care or insurance environment

  • Minimum of three (3) years of customer service experience in a call center environment and knowledge in claims processing and HMO, PPO and/or Medicare managed products

  • Demonstrated experience in driving service improvements

Skills & Abilities:

  • Must demonstrate excellent verbal and written communication skills

  • Must be able to maintain the highest degree of tact and diplomacy

  • Must demonstrate a very high degree of maturity, poise, flexibility and good judgment in responding to inquiries from customers with varying attitudes

  • Must demonstrate strong analytical and problem solving skills

  • Must demonstrate leadership skills that promote teamwork and staff engagement

  • Must demonstrate the ability to analyze report data and forecast results for performance improvements.

  • Demonstrate a clear understanding of health care delivery systems

  • Demonstrate understanding of HMO/AHL health care concepts

  • Demonstrate human relations management skills

  • Demonstrate technical understanding of database oriented computer systems, i.e. FACETS, PEGA

  • Demonstrate proficient use of Microsoft Office software applications, i.e., Word, Excel, Power Point


    Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health

    care systems, is a national leader in clinical care, research and education. The system includes

    the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health

    insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory

    network and many other health-related entities throughout southeast Michigan, providing a

    full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care.

    The health system also is a major economic driver in Michigan and employs more than 24,600

    employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The

    health system is led by President and CEO Wright Lassiter III. To learn more, visitHenryFord.com.


    Whether it's offering a new medical option, helping you make healthier lifestyle choices or

    making the employee enrollment selection experience easier, it's all about choice. Henry

    Ford Health System has a new approach for its employee benefits program - My Choice

    Rewards. My Choice Rewards is a program as diverse as the people it serves. There are

    dozens of options for all of our employees including compensation, benefits, work/life balance

    and learning - options that enhance your career and add value to your personal life. As an

    employee you are provided access to Retirement Programs, an Employee Assistance Program

    (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness

    and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other

    benefits and services.

    Equal Employment Opportunity/Affirmative Action Employer

    Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.