UPMC Health Plan has an exciting opportunity for a Team Lead, Member Engagement position for the Member Services department. This is a full time position working various hours and will be a hybrid position working from home and in office. Must be in the Pittsburgh and Erie area to be considered.
Provide technical and plan support to the Member Services Areas while adhering to our UPMC Values. Ensure excellent customer satisfaction for both internal and external customers according to our service excellence model. Effectively monitor calls queues and volumes to support the team?s success. Assist with the development and training of new team members as needed.

• Continually examine team performance, provide feedback, make recommendations and implement action plans to meet designated standards. Assist Team Development Coach with responsibilities as needed to ensure completion of coaching.Continually monitor representative performance and collaborate with Coaching Lead to support as needed.
• Plan and conduct monthly team meetings. Maintain employee and insured confidentiality. Assist in the resolution of difficult claim inquiries; provide expert certificate of coverage interpretation and system support. Support other departments as requested during periods of backlogs. Flexible schedule based on business needs including weekends, evenings and holidays.
• Monitor and manage queue volumes. Interface with customers via telephone, correspondence and/or in person to answer inquires, resolve concerns, and ensure customer satisfaction and attainment of all performance standards. Participate in corporate/department trainings.
• Monitor and refine workflow to facilitate communication and teamwork between departments. Maintain reports and identify root cause of potential trends or existing problems. Complete special projects as assigned. Conduct power summits and training of team members when requested.
• Support team members and their knowledge on the Resource Unit by using screenshare or step by step instructions to ensure resolution and understanding.Support escalated member issues on the Supervisor line.Support team members side-by-side as needed.
• Support and develop cross-functional team members. Maintain a positive work environment through employee recognition and daily interactions.Serve as a role model to promote positive behavior.
• High School Diploma.
• Bachelor’s Degree Preferred.
• 2 years experience in Insurance, Managed Care, Benefit’s Administration environment or Customer Service environment.
• Excellent organizational, interpersonal and communication skills.
• Ability to succeed in a fast-paced environment.
• Expert knowledge of health plan products and functions.
• Strong analytical ability.
• Keyboard dexterity.
• MS Office/PC skills.LICENSURE, CERTIFICATIONS, AND CLEARANCES:
• Act 34