Call Center Team Lead - TRICARE (Remote)

Description & Requirements

Summary

This program provides virtual customer service in support of beneficiaries, family members, military personnel, and medical providers.

Using a patient-centric approach, the TRICARE Support team will assist callers to navigate and answer TRICARE program benefit questions, update the beneficiary demographics in the government system, change the Primary Care provider for the beneficiary and/or family, assist with claim questions, and other calls related to the TRICARE program.

To work on this program, the staff must be able to meet the ADPII Tier 1 government clearance.

Overview

Navigators use their advanced knowledge of military health call center operations and service delivery to resolve escalated issues, cases, concerns, and inquiries.

Will act as a resource for the TRICARE Support Representative (TSR) team to assist with questions, escalations and complex issues.

Reinforce Maximus' Federal's highest standards of customer service and excellence by monitoring TSRs and providing feedback to ensure empathetic, accurate, compliant, and efficient service is provided to all callers.

Support team supervisor to ensure daily goals, quality case coordination, and shift priorities are accomplished on a consistent basis.

Essential Duties and Responsibilities:
- Assists supervisor/manager with the management of daily activities over a group of agents that handle customer service inquiries and problems via the telephone and sometimes e-mail.
- Provides direction and guidance to less experienced team members and provides coaching on how to handle more complex inquiries.
- Recognizes and recommends areas needing improvement.
- May assist in scheduling and coordinating team activities.
- May provide input into hiring decisions and performance appraisals, but does not necessarily make hiring decisions or conduct performance appraisals.

- Act as a TRICARE subject matter expert (SME) for TSRs to answer questions, provide
recommendations, and resolve escalated issues.

- Monitor TSRs to ensure calls are answered promptly, appropriately, and courteously.

- Provide feedback to TSRs to help them improve quality, productivity, efficiency, and better
understanding of policies, procedures, and systems.

- Support new TSRs in the nesting phase after training through monitoring, feedback, and SME support.

- Resolve complex or escalated concerns with informed and objective responses regarding program
eligibility requirements, enrollments and program benefits.

- Deescalate and manage complaints in a professional manner, resolving them wherever possible.

- Meet Quality Assurance (QA) and other key performance metrics and maintain knowledge of project
policies and procedures.

- Monitor active participation in and support departmental and organizational quality initiatives and goals.

- Maintain effective interdepartmental relationships and interaction with peers to create a cohesive and
productive environment.

- Assist with cont...