Benefit Operation Manager

Role Purpose

The purpose of this role to deliver great customerservice/experience by effectively acknowledging, tracking, andprioritizing all client cases as per the regulatory guidelines, andensuring resolution as per the defined SLAs, by allocating the same tothe relevant support team.

Do  

1. Ensure operational excellence through contract andregulatory compliance, effective case acknowledgment, tracking,prioritization, system updation, and reporting

   1. Acknowledge client cases as per the SLA’s defined in thecontract
   2. Access client tool and log all incoming client cases accuratelyon the internal tool as per contract
   3. Accurately document all pertinent case information such as casenumber, case type, etc. of daily cases received
   4. Follow standard processes and procedures to track and prioritizeall client cases
   5. Accurately update the internal tool with daily cases and forwardthe same to respective agents and QAs
   6. Access and maintain internal knowledge bases, resources andfrequently asked questions to aid in effective case logging andprioritization
   7. Maintain and timely update internal tool for agents to speed upresponse time
   8. Identify red flags and escalate serious client issues to Teamleader in cases of non-compliance and untimely resolution
   9. Ensure all client information, disclosures and regulatorychanges are given to agents and QA’s on a regular basis
   10. Monitor compliance with service agreements to avoid legalchallenges
   11. Share recorded case logs and status reports with clients andsupervisors on a daily basis

2. Deliver excellent customer service through effectiveunderstanding of client tool, accurate case logging and prioritizationas per regulatory guidelines

   1. Serve as the primary point of contact for accessing casespertaining to a specific client using designated client tool
   2. Develop deep understanding and use of client tool to effectivelyperform day today duties
   3. Access client tool and acknowledge to the client the receipt ofthe cases as per the SLA’s defined in the contract
   4. Accurately document all pertinent case information such as casenumber, case type, etc. on a daily basis for all cases received
   5. Prioritize cases on the levels of urgency and complexity as perthe regulatory guidelines defines by the client
   6. Accurately extract case information and create an excel listingcases along with relevant information pertaining to the cases
   7. Maintain logs and records of all client cases as per thestandard procedures and guidelines
   8. Collaborate with client and undergo trainings on any newregulatory guidelines for a particular client process and implement thesame on all cases

3. Ensure allocation and resolution of client cases as per thedefined SLAs by accurately updating internal tools, training sessions onnew regulations and regular reporting

   1. Ensure allocation of cases to agents and QAs by accuratelyrecording all client cases on the designated internal tracking software
   2. Maintain tracker of all cases received along with the allocationinformation for reporting purposes
   3. Ensure all client cases are resolved as per the definedSLA’s and regulatory guidelines defined by the client
   4. Maintain and share the resolution status report with supervisorand client on a daily basis
   5. Share the hourly productivity update report with supervisors andclients on a daily basis
   6. Undertake client training on specific tool features and/or anyother regulatory changes introduced by client/govt.
   7. Conduct training sessions for agents and QA ensuring theregulatory changes have been effectively communicated to all agents andQAs
   8. Ensure new regulatory guidelines are implemented all clientprocesses to avoid penalties and non-compliance
   9. Liaise between the client and internal teams on escalations ofserious issues and unique queries
   10. Follow up with agents and QAs to record feedback and ensurecompliance to contract SLA’s and regulations
   11. Interact and engage with the client and internal stakeholders tocommunicate and update progress against a particular case

4. Build capability to ensure operational excellence andmaintain superior customer service levels for the existing client

   1. Undertake trainings to stay current with any new features,changes and updates on client tool
   2. Enroll in product specific and any other trainings per clientrequirements/recommendations
   3. Conduct training sessions for Agents and QAs on any newregulatory guideline that needs to be applied to any process urgently
   4. Identifying and document most common problems and recommendappropriate changes to the team leader
   5. Updates job knowledge by participating in self learningopportunities and maintaining personal networks

Stakeholder Interaction

| | | | | --- | --- | --- | | Stakeholder Type | Stakeholder Identification | Purpose of Interaction | | Internal | Team Leaders | Process Improvements, Reporting | | Agents & QA’s | Case logging, forwarding, resolution | | Training Team | Capability development | | Quality | Case resolution & response time | | External | Client | Case tracking, reporting, acknowledgement, case prioritization as perregulatory guidelines, trainings & certifications |

Display

Lists the competencies required to perform this role effectively:

• Functional Competencies/ Skill
  • Process/ technical Knowledge – Knowledge of process, processand tools - Expert

| | | | --- | --- | | Competency Levels | | Foundation | Knowledgeable about the competency requirements. Demonstrates (inparts) frequently with minimal support and guidance. | | Competent | Consistently demonstrates the full range of the competency withoutguidance. Extends the competency to difficult and unknown situations aswell. | | Expert | Applies the competency in all situations and is serves as a guide toothers as well. | | Master | Coaches others and builds organizational capability in the competencyarea. Serves as a key resource for that competency and is recognizedwithin the entire organization. |

• Behavioral Competencies
  • Collaborative working
  • Problem solving and decision making
  • Attention to Detail
  • Execution Excellence
  • Stakeholder Management
  • Client (Internal) Centricity
  • Effective Communication

Deliver

| | | | | --- | --- | --- | | No. | Performance Parameter | Measure | | 1. | Financials | Case prioritization as per client SLA and regulations, resolutiontime, penalties due to non-compliance | | 2. | Customer | PCSAT and ACSAT score, Pulse score, Customer cases – received,time to forward, time-to-closure, customer references, positive customerfeedback | | 3. | Account Management | no. of cases forwarded to support staff, no. of cases resolved perday, accurate reporting, prioritizing cases as per regulations | | 4. | Team Management | Training Hours, No of technical training completed, no. of trainingsconducted |