Triage Operations Supervisor

This is a primarily remote position, but you must be located in North Carolina.

About CCHN: Carolina Complete Health Network was founded in 2016 and is North Carolina’s only Physician-Led Medicaid Plan (also known as a Provider Led Entity). It’s the result of a collaborative joint venture between the NC Medical Society, the NC Community Health Center Association, and Centene Corporation.  We give medical care providers and Federally Qualified Health Centers (FQHC) a voice in policymaking which ultimately results in better patient outcomes, helping patients get the care they need when they need it through local, regional, and community based resources.   

Position Purpose: Reporting to the Area Manager(s), the Triage Operations Supervisor provides focused leadership, support, and supervision to the Carolina Complete Health Network telephone triage team. This role ensures that all provider communications are handled professionally, with appropriate follow-up and resolution. The Triage Operations Supervisor is responsible for team development, process improvement, provider interactions, performance monitoring, and strategic growth.  This position will be provider facing in external meetings and as representative of the Provider Experience Team, engaging with external providers and stakeholders as needed.  

Essential Functions and Responsibilities:  

Team Leadership 

• Model exemplary leadership for the team – demonstrate positivity, support, and accessibility for your team, peers, and leadership. Foster a culture of mutual respect and collaboration, where support is given and expected in return. 

• Work with your team to ensure their individual understanding of performance expectations, including but not limited to:  

  • E-mail communication 

  • Call response times w/providers  

  • Following SOP 

  • When and how to escalate a concern and follow up 

  • How to manage a provider conflict 

  • Professional meeting management 

  • Professionalism (appearance, conduct and communication) 

  • When to leverage external team support (HR, Provider Education, Medical Policy, etc....) 

• Monitor Key Performance Indicators (KPIs) and adjust team strategies accordingly 

• Guide staff performance, providing constructive feedback, and addressing development opportunities in regularly scheduled 1:1’s with Supervisors and skip level meetings accordingly 

• Regularly monitor calls to evaluate staff performance and identify coaching opportunities 

• Support hiring activities in conjunction with Area manager, Provider Experience and/or Sr. Director, Provider Experience 

Call Volume Management 

• Evaluates and assesses queues to ensure limited wait times, adherence to lunch and break times, after call work, and responds as appropriate with team members 

• Schedule staff to ensure adequate coverage during peak call volumes, accounting for PTO, sick leave, lunch time, and breaks 

• Supervision and approval of PTO and Expenses adhering to CCHN policy 

• May handle routine calls if needed to assist the team if calls are held in the queue 

Data and Trend Analysis 

• Reviewing QuickBase (and other applicable databases) documentation to ensure appropriate responses/decision-making and follow-up was completed and ensuring that documentation is following SOP  

• Monitor team QuickBase documentation, completion of Omni Intents, and Email communications on a weekly/monthly basis.  (View month over month performance) Review monthly and address concerns as needed.  Address training needs and comparative performance 

• Analyzing data to identify trends and implement necessary changes to improve triage team performance 

• When reporting workload concerns to Area Managers and Sr. Director use quantifiable measures to raise concerns (ex: # of calls, intents, emails, meetings over what duration of time [daily, weekly, monthly…], delineate in work required to support the complexity of provider or health system, volume, and scope of projects, etc.) 

• Develop strategies and parameters to effectively gauge the potential need to expand the phone triage team based on data analysis in collaboration with management team 

• Provide monthly report to manager, recapping team performance 

SOP and Training Development 

• Develop and maintain scripts and guidelines as needed in accordance with SOPs and as requested by management in collaboration with Provider Experience Team Trainer 

• Assist in adjustment and development of triage workflows and SOPs 

• Participates and assists with the development of staff training, coaching, and education based on observations, planning in-service, and other meetings as needed or assigned in collaboration with Area manager of Provider Experience and Provider Experience Team Trainer   

Communication and Escalation Resolution 

• Serve as a point of escalation for customer issues that cannot be resolved by the team 

• Serve as a liaison between the Provider, the health plan, and others, in support of your team and department.  Also, as needed or requested by your staff, mgmt., or the provider themselves to assist with issue resolution or escalation as needed. 

• Work with the phone triage team to reduce escalations, provider conflict, and increase provider satisfaction whenever possible through timely, professional response to calls, questions, and resolution 

• When large in scope, or key provider issues arise (or appear to be developing) include your Area Manager for awareness, guidance, support, and escalation, if needed 

• Cross communicate with other PX Team Supervisors to identify developing trends, concerns, etc. (internally and externally) and share with leadership proactively 

• Communicating and collaborating effectively with the phone triage team, providers, as well as internal and external stakeholders 

• Communicates with Provider Experience Area Managers and Provider Experience supervisors as necessary to ensure cohesion of team related to work-flow operations,  warm transfers, and collaboration to ensure issue resolution and quality outcomes 

• In person meetings as required (Onboarding, Supervisor meetings, Evaluations, Trainings, etc.)  

Global Responsibilities for all staff: 

• Follow State mandated guidelines in relation to Provider Relations, Contracting and Medicaid Transformation  

• Protect confidential and sensitive business information, complying with Centene in NC firewall system, HIPPA, and CCHN partners  

• Completed required CCHN and Centene training, as assigned 

• Travel as needed (estimated 10%) 

Required Qualifications:   

• Minimum of 3 years of progressive experience in a call center or customer service management role, with a proven track record of growth, innovation, and excellence. 

• Strong leadership skills with experience in team expansion and development. 

• Ability to serve as an empathetic leader (actively listens and problem solves when team member struggles arise) while maintaining a high bar of growth and performance for the team.  

• Proficiency with all Microsoft Office applications, especially Excel, Teams, and Outlook.  

• Excellent communication skills (including grammar, spelling, tone, and body language), enthusiasm, and the ability to engage with an audience  

• Strategic thinking and business insight for identifying and capitalizing on growth and performance improvement opportunities. 

• Ability to handle multiple tasks at a time in a fast-paced environment as an example to your team  

• Willingness to dig in and problem solve, then put a plan into action and see it through completion 

• Reliable high speed internet connection and the ability to work effectively independently from a home office (this role requires candidates to be located in North Carolina but is primarily remote).  

Preferred Qualifications:  

• Bachelor’s degree in healthcare administration, Business Administration, or equivalent industry experience  

• Knowledge of healthcare, managed care, Marketplace, or Medicaid insurance(s) is a plus  

• Current state driver’s license  

CCHN Benefits

We offer a comprehensive benefits plan to help you care for you and your family's wellbeing:

• Medical, Dental, and Vision insurance plan offerings with a portion of premiums covered by CCHN (HSA and FSA eligible plans available!)

• Short/Long Term Disability and Supplemental Life Insurance included, as well as add-on options

• Annual wellness reimbursement

• 401k with company match

• Paid parental leave

• Paid time off

Carolina Complete Health Network is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.