Call Center Supervisor Clinical - AbbVie

Job Title: 

XRN05G – Call Center Supervisor (Clinical) - AbbVie

Brief Description:  

Patients are at the center of our business strategies.  The Clinical supervisor is responsible for: managing the daily operations of the clinical team in the area of medical management operations, inclusive, but not limited to maintaining production metrics, delivering on current service level agreements, fulfilling contractual requirements, and supporting future state initiatives while meeting strategic, operational and budgetary targets.   Additionally, this position will partner with leadership to continue the development of clinical quality programs.   In collaboration with key business partners, the supervisor-RN Clinical will identify operational opportunities and areas for process development, improvement, and administration applicable to clinical product offerings and present recommendations to leadership.   Supervises and coordinates daily activities of business support, technical support, or production team at entry level and/or at non-exempt levels using established policies and procedures.   Sets priorities for soundness of decision-making and overall quality and efficiency.

Specific job duties:

Responsible for implementing and maintaining the effectiveness of the program by:

• Monitor operational performance relating to Operations metrics, Quality measures, Contractual requirements, Execution of MBM policies and procedures and Clinical appropriateness.
• Monitor the daily administration of clinical programs, including application of medical policy, utilization management processes and practices while remaining compliant with contractual and regulatory requirements.
• Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
• Provides department leadership in the area of staff performance including mentoring, auditing, productivity monitoring and coaching for success.   Corresponds with management on employee /HR issues, state of the department and any service issues involving key clients or legal risk issues to the company.
• Analyse reporting data trends within team relative to quality to ensure efficiency and productivity requirements are maximized.  Provide feedback to team related to productivity and efficiency.
• Continual identification of operational opportunities to gain efficiencies, improve processes and workflow and develop best practices.
• Travel to and attend related meetings/conferences as required.
• Other duties as assigned.

Supervisory Responsibility:  

2 – 15 Direct Reports

Desired Skills and Qualifications:

• Bachelor’s degree in relevant discipline or equivalent work experience
• 2-5 years relevant experience, or master’s degree
• Registered Nurse License in good standing in the state in which you work and/or cross-licensed in other states
• Telephonic nursing roles are required to have (or be willing to obtain) a Compact State License in eligible states; additionally, the employee must be willing to obtain additional Single State Licenses upon request. Excellent PC skills including Microsoft Office and Internet experience
• Solid PC Navigation skill set
• Excellent verbal and written communication and presentation skills
• Solid understanding of the health insurance industry
• Ability to navigate and support both public and private insurance/plan requirements
• Managed care experience
• Understanding or ability to implement utilization management principles
• Proven leader in a clinical ops environment
• Ability to analyze information and target trends
• Organize people and systems to achieve goals

Benefits: 

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally. 

Here are some of the exciting perks UBC offers: 

Remote opportunities 

Competitive salaries 

Growth opportunities for promotion 

401K with company match* 

Tuition reimbursement 

Discretionary PTO (Paid Time Off) 

Paid Holidays 

Employee assistance programs 

Medical, Dental, and vision coverage 

HSA/FSA 

Telemedicine (Virtual doctor appointments) 

Wellness program 

Adoption assistance 

Short-term disability 

Long term disability 

Life insurance 

Discount programs 

UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class.  We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.

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