Customer Service Representative - Lead; Bilingual

Customer Service Representative – Lead (Bilingual)

Cal Optima

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

We are hoping you will join us as a Customer Service Representative – Lead (Bilingual) and help shape the future of healthcare where you'll be an integral part of our CS – Medi-Cal Call Center team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders.

This position has been approved to be Partial Telework
.

If telework is approved, you are required to work within the State of California only. If Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

The Customer Service Rep – Lead will provide services to Cal Optima Health members and providers. You will assist members and providers with questions related to the Medi-Cal and One Care programs for Orange County, provide information regarding eligibility, enrollment and benefits to Cal Optima Health members, and member eligibility information to Cal Optima Health providers, and serve as a mentor and resource for Customer Service Representatives (CSRs).

Together, we are building a stronger, more equitable health system.

• 95% – Program Support
  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Monitors key performance indicators to ensure regulatory requirements are achieved and maintained.
  • Processes member and provider information.
  • Answers member and provider questions in-person or telephonically.
  • Refs issues interdepartmentally and makes recommendations for further contacts within Cal Optima Health.
  • Documents contact information via the Facets computer system.
  • Functions efficiently and productively in a high-volume telephone call center and maintains departmental performance and productivity standards.
  • Handles or routes escalated calls appropriately.
  • Assists supervisor with daily monitoring of customer service tasks, projects and case queues.
  • Assists supervisor with CSR monthly performance reports and provides feedback for annual CSR evaluations.
  • Monitors and addresses queue volume and wait times.
  • Aids leadership in identifying and resolving operational problems using defined processes, expertise and judgement.
  • Collaborates with supervisors and interdepartmentally to develop strategies to reinforce, train and disseminate information to meet operational and service performance requirements.
  • Contributes subject matter expertise and carries out project assignments in a timely and effective manner by adhering to company and departmental policies and procedures.
  • Sends daily call center reports.
  • Assists with coordination of staff meetings and presentations.
• 5% – Other
  • Completes other projects and duties as assigned.

• High school diploma or equivalent PLUS 3 years of customer/member services experience, including 2 years of call center capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• Bilingual in English and in one of Cal Optima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese) required.

• 2 years of experience in health maintenance organization (HMO), Medi-Cal/Medicaid and health services experience.

• None