Member Advocate Supervisor

Full Time

About the Role

The Member Advocate department work in concert with pharmacists and pharmacy technicians to provide exceptional services to our members. Member Advocates are the first point of contact to patients and serve as the voice of Tria Health. This position is extremely critical in our success and our patients’ overall satisfaction. The Supervisor will assist in the supervision of the Member Advocates (MAs) and perform a variety of other administrative duties.

Essential Duties and Responsibilities

Essential Duties and Responsibilities:

  • Document call statistics weekly and monthly in the appropriate spreadsheets.

  • Assist with the monitoring of MA calls and documentation practices within Smart Rx weekly.

  • Assist with escalated calls.

  • Ability to address patient complaints and resolve those concerns with the patients and MAs.

  • Assist with MAs’ monthly, quarterly, and annual reviews.

  • Maintain and update MA training manual and other training materials.

  • Assist with development and revisions of policies and procedures.

  • Serve as back up to the Member Advocate and Quality Assurance Manager.

  • Serve as back up to the MAs.

  • Ensure all assigned tasks are performed correctly and timely to meet performance standards.

  • Monitor 5 MA calls per shift, per month for quality purposes.

  • Compile trigger reports and ensure trigger packets are being mailed in a timely manner.

  • Continually strive to improve all process efficiencies using tools provided through PIPS.

  • Oversees the patient reimbursement process to ensure they are processed in a timely manner.

  • Assit with training of new and existing MAs/MES as needed.

  • Plan, assign, and direct the work of the MAs.

  • Assist in selection and onboarding of new employees.

  • Assit with coaching and mentoring of employees to be successful and achieve company goals.

  • Assist with counseling and disciplining employees for maximum productivity and success.

  • Make outbound calls to pharmacies, doctor's offices, TPAs and PBMs.

  • Work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise to balance the workload.

  • Varying shifts may be required, including extended evening and weekend hours.

  • Commitment to Tria’s mission, vision, values, and handbook.

  • Other duties as assigned.

Qualifications

  • Understanding of word processing, spreadsheet, database, electronic mail, and internet.

  • Work effectively with all levels and disciplines of management and staff.

  • Handle multiple interruptions and adjustments to priorities throughout the day.

  • Ability to organize effectively, set priorities, manage workload, and handle multiple responsibilities in order to meet deadlines.

  • Ability to apply concepts of basic algebra and geometry.

  • Ability to interpret a variety of instructions furnished in written, verbal, diagram, or schedule form.

  • Perform duties at a high degree of accuracy.

  • Strong team player and willingness to work in other functional areas to cover absences or relief, and/or to equalize peak work periods or to otherwise balance  the workload.

  • Ability to communicate calmly and effectively with diverse population, both verbally and written form.

Success Factors:

· Problem solving.

· Analytical ability.

· Interpersonal skills.

· Communication skills.

· Leadership skills.

· Attention to detail.

· Self-motivated.

Education/Experience

  • High school graduate or equivalent education. College degree or college coursework is strongly preferred.

  • Minimum of 1-2 years management experience in multi-functional customer service environment or similar experience is preferred.

  • Previous supervisory experience of at least one year is required.

  • Health insurance experience is strongly preferred.

Physical Demands and Work Environment

The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Physical Demands:  While performing the duties of this job, the individual is regularly required to stand, bend, kneel, sit, walk, and use hands to finger, handle, or feel objects; reach with hands and arms; talk and hear. The vision requirements include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Individual must occasionally lift and/or  move up to 20 pounds.

  • Work Environment:  This job operates in a  professional office environment where standard office equipment such as  computer, phones, photocopiers, filing cabinets and fax machines are  utilized. The noise level in the work environment is usually minimal. Mail room noise is considered moderate periodically.

  • Office Hours:  Monday - Thursday 12 - 9 pm and Friday 10 - 7 pm or as business needs dictate. 

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