Referral/Call Center Manager

OVERVIEW

NHHA is committed to employee well-being and maintaining a healthy work-life integration. The information given below is intended to provide an understanding and appreciation of the workload of the job and its role within NHHA. The job description outlines the main purposes in general terms only. You may be required to carry out other duties in order to commensurate with the job. This will not change the character or purpose of the job but will be necessary to maintain high standards of business practice. This job description may be altered from time to time to meet the changing needs of the company.

JOB SUMMARY

We are seeking a compassionate and results-driven Call Center Manager to lead and manage a team responsible for receiving, triaging, and processing incoming referrals for multiple nonprofit organizations in different locations. The ideal candidate will have a strong background in call center operations, understanding of healthcare, recuperative care, and other social services under Medi-Cal, and the ability to lead a team in a fast-paced, client-centric environment.

The Call Center Manager will ensure that all referrals are triaged appropriately, documentation is in order, client eligibility is verified, insurance coverage is confirmed, and the right level of care is assigned based on client needs. This position requires a leader who can foster empathy, build operational efficiency, and ensure that all team members are trained and empowered to meet the highest standards.

In this role, you will also be responsible for building and developing new teams and implementing systems that support the efficient management of referrals. If you have a proven track record of establishing new teams, developing workflows, and optimizing systems to drive success, we encourage you to apply.

As the Call Center Manager, you will also oversee performance, identify areas for improvement, and report regularly on key metrics. On-Call Support will be required as needed to handle urgent matters outside of regular business hours.

KEY RESPONSIBILITIES

• Manage Call Center Operations: Oversee the daily activities of the call center, ensuring optimal performance in handling referrals for multiple nonprofit organizations.
• Team Management: Build, lead and manage a team of Referral Managers and other staff, including hiring, training, and performance management.
• Technology Oversight: Ensure the call center is utilizing the appropriate technology (e.g., Dialpad or similar systems) for effective call routing and performance monitoring. Troubleshoot and resolve any technical issues as needed.
• Referral Management:
• Prepare and manage staff to respond to incoming requests for services and refer them to appropriate services. Support subcontracted ECMs to identify resources available to them for their closed-loop referral management. Develop and deploy processes to monitor all referrals to assure all are successfully closed.
• Direct the flow of referrals, ensuring timely and accurate processing in line with the needs of the nonprofit partners.
• Collaboration with Nonprofits: Serve as the main point of contact between the call center and the nonprofit organizations, ensuring effective communication and alignment on referral handling.
• Customer Service & Support: Maintain a strong focus on customer service, ensuring that referrals are handled in a compassionate and professional manner.
• Outreach and Engagement: Guide staff to outreach to individuals on health plan's monthly Member Information Files (MIFs) to engage them in ECM and other needed services. Outreach may be telephonic, in the community, or other means best suited to the targeted population.
• Population Health Management and Quality Improvement: Conduct and guide staff to utilize data to identify population segments requiring special interventions and/or care processes needing improvement to assure subcontractor programs maximize effectiveness.
• Resource Identification: Manage staff to identify and develop relationships with health and social service providers in the community to support subcontracted Lead Case Managers in their Enhanced Care Management (ECM) of assigned clients. Manage staff to create and maintain a resource directory for NHHA subcontracted provider partners.
• Case Conferences: Manage staff to plan and facilitate weekly multi-disciplinary case conferences with subcontracted Lead Case Managers and program staff in the NHHA System of Care.

ECM Program Support:

• Assist in Monitoring subcontracted ECM programs to assure processes are delivered per NHHA, health plan and DHCS standards of practice in tandem with key stakeholders within NHHA (SVP & General Counsel, Senior Advisor of QI & Advanced Project Management and Manager of Contracts & Provider Relations).
• Help maintain accurate and updated documentation of client assessments, care plans, and interventions.
• Maintain the resources and contacts to connect patients with appropriate healthcare services, community resources, and support programs.
• Help provide support and intervention during medical emergencies or crises.
• Implement initiatives to enhance program efficiency, effectiveness, and overall patient satisfaction.
• Provide and/or participate in training modules to standardize best practice among care management personnel.
• Foster a collaborative and supportive work environment that promotes teamwork, professionalism, and excellence in patient care.

Quality Assurance and Compliance:

• Ensure NHHA and subcontractors' compliance with all relevant regulations, standards, and policies governing the programs managed through the call center.
• Work with key NHHA stakeholders (SVP & General Counsel, Senior Advisor of QI & Advanced Project Management) to continuously implement quality assurance measures to evaluate the effectiveness of all programs and services serviced by the call center.

Stakeholder Engagement and Collaboration:

• Establish and maintain effective partnerships with internal stakeholders, including clinical teams, administration, and support staff.
• Collaborate with external partners, such as community organizations and healthcare providers, to coordinate care and support services for clients in the community care campus locations.

POSITION REQUIREMENTS & QUALIFICATIONS

Experience:

• Minimum of 3-5 years in call center management or related roles. Experience in healthcare management, with a focus on complex care or care coordination of vulnerable populations a plus.
• Knowledge of regulatory requirements and best practices in healthcare management a plus.
• Experience in managing healthcare or social services-related call centers preferred.
• Familiarity with referral management processes and systems is a plus.

Skills:

• Demonstrated ability to lead teams effectively by setting clear goals, providing guidance, and fostering a collaborative and supportive work environment that inspires and motivates team members.
• Proficient in call center technologies, such as Dialpad, call routing systems, or similar platforms.
• Excellent communication and interpersonal skills, with the ability to convey complex information clearly and effectively to diverse audiences, including team members, health professionals, clients, and nonprofit partners. Effective telephone skills.
• Strong problem-solving skills, especially when dealing with operational challenges or customer issues. Ability to work independently and flexibly.
• Bachelor's degree in healthcare administration, or related field; master's degree preferred.
• Proven ability to develop and implement innovative programs and workflow or system efficiency and effectiveness.
• Demonstrates professionalism and sound judgment in directing operations and handling sensitive and confidential issues. Good organizational skills to handle multiple priorities while remaining professional and calm.

General Expectations:

• Be committed to the mission of NHHA.
• Behave in a professional manner and consistently demonstrate and promote the values of respect, honesty, and dignity for the patient, families, and all members of the healthcare team.
• Committed to the constant pursuit of excellence and teamwork in improving the care of the patient and families of NHHA and its subcontract provider partners.
• Be punctual for scheduled work and use time appropriately.
• Perform duties in a conscientious, cooperative manner.
• Perform required amount of work in a timely fashion with a minimum of errors.
• Be neat and maintain a professional appearance.
• Maintain confidentiality and protect the Practice by abiding by laws and principles related to confidentiality; keep information concerning program operations, patients and employees confidential.
• Successfully complete background check.
• Maintain compliance with NHHA's compliance standards, including its Standards of Conduct, Compliance Program, and policies and procedures.

NHHA is an equal opportunity employer and welcomes candidates from diverse backgrounds. We offer competitive salaries and benefits packages, as well as opportunities for professional growth and development.

Job Type: Full-time

Pay: $85,000.00 - $95,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to Commute:

• Long Beach, CA 90804 (Required)

Work Location: In person

Salary : $85,000 - $95,000