• Direct responsibility for hiring and termination decisions. • Real‑time performance management — oversee attendance, provide coaching, and ensure agents meet all KPIs and compliance standards. • Deliver constructive feedback and conduct training sessions to support agent development. • Respond to escalated calls when callers request a supervisor callback. • Review agent timecards for accuracy and compliance with organizational policies. • Monitor Real‑Time Adherence (RTA) and ensure appropriate staffing coverage throughout the day. • Conduct real‑time monitoring to maintain service levels and operational efficiency. • Prepare daily, weekly, and monthly reports summarizing performance metrics, trends, and operational insights.

Role Description Our client is seeking an experienced Supervisor to oversee audits/investigations and audit/investigation workload. In the role you would perform in-depth evaluation and make field level judgments related to audits/investigations of potential Medicaid Managed Care fraud waste and abuse audits/investigations or compliance cases (e.g. Medicare and/or Medicaid) that meet established criteria for referral to the appropriate agency(ies) for administrative action or to law enforcement for criminal action. - Reviews new audits/investigations and/or incoming leads to determine appropriateness and assigns to auditors/investigators; vets providers as required with appropriate agency(ies) and law enforcement; supervises vetting process. - Reviews audit/investigation plans and priorities to ensure appropriateness and quality for the specific functions/workload assigned to team. - Conducts file reviews regularly of audits/investigations to ensure audit/investigation plan is appropriate and the audit/investigation file documents are entered and summarized within the case tracking systems appropriately. - Reviews auditor/investigator requests for information, data, reports, and correspondence to ensure quality and appropriateness. - Supervises and conducts audit/investigation actions such as interviewing, onsite audit/investigation, and/or site verification as needed. - Leads audit/investigation projects including developing an audit/investigation strategy, conducting meetings with stakeholders, reviewing project actions for quality, and documenting findings in reports for management. - Communicates with the Data and Medical Review departments to ensure efficient audits/investigations. - Prepares and presents audits/investigations, overpayments, and questions for stakeholder meetings. - Documents audit/investigation information and file reviews (interviews, events, findings, communications, etc.) into the case tracking systems and updates systems as needed. - Determines audit/investigation appropriateness of fraud, waste, and abuse issues in accordance with pre-established criteria. - Reviews audit/investigative findings with auditors/investigators and approves course of action. - Supervises and prepares team’s audits/investigations for the Major Case Coordination meetings and reviews for quality assurance. - Initiates and maintains communications with law enforcement and appropriate regulatory agencies including presenting or assisting with presenting audit/investigation findings for their consideration to further audit/investigate, prosecute, or seek other appropriate regulatory or administrative remedies. - Supervises administrative remedies in accordance with major case coordination direction (e.g. payment suspensions, revocations, provider education) and reviews for quality assurance. - Reviews and approves closing summary of audit/investigation. - Collects information and documentation as requested by internal and external stakeholders (e.g. CMS, law enforcement, FOIA requests) and submits, as required. - Collaborates with other program integrity contractors, as needed. - Testifies at various legal or administrative proceedings, as necessary. - Manages team performance through regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development. Qualifications - Minimum Bachelor's Degree required - 5 - 7 years of experience required; 8 - 11 years preferred - Medicaid Managed Care experience preferred Requirements - Current, active and non-restricted RN licensure required. Company Description Established in 2010, @Orchard LLC, also known as Talent Orchard, has an exceptional reputation, providing staffing solutions to time-sensitive, talent scarcity issues to deliver better talent management ROI. Our specialty lies in the critical area of program talent acquisition and resource management, not in one narrow skillset, but across many areas of technical and functional delivery. To learn more about our other exciting opportunities, visit our Jobs Page at www.atOrchard.com .

Role Description The ideal candidate would be someone who has 2+ years of call center experience in a target-driven environment. Experience working in an outbound sales process is a plus. Outgoing and pleasing personality on the phone. Excellent communication skills with clear diction. Good time manager. Ability to multitask and work in a challenging environment. Ready to learn and grow. Go-getter mindset. Key Responsibilities - Answering or making calls to members to book appointments for their no-cost In-home Health Assessments. - Learn about and address customer needs, complaints, or other service issues. - Responding efficiently and accurately to callers, explaining possible solutions/rebuttals, and ensuring that customers feel supported and valued. - Engaging in active listening with callers, confirming or clarifying information, and diffusing angry clients, as needed. - Building lasting relationships with customers and other call center team members based on trust and reliability. - Utilizing software, databases, scripts, and tools appropriately. - Understanding and striving to meet or exceed call center metrics while providing excellent, consistent customer service. - Making sales or recommendations for products or services that suit client needs better. - Taking part in training and other learning opportunities to expand knowledge of the company and position. - To be available on meetings on camera as and when needed. - Adhering to all company policies and procedures. - Additional ad-hoc tasks as assigned by the Call Center Supervisor. Qualifications - Outgoing personality and sales approach. - Solid work history, citing any recognition and promotion. - Ability to thrive in a fast-paced, energetic environment doing multi-tasking on the system while talking to the customer on the phone. - Customer service or other directly related experience is a plus. - Ability to collaborate and be a team player. - Various software and data entry proficiency, including MS Office. - Ability to type 40Wpm, 60Wpm is preferred. - Strong communication and time management skills. - Supreme ability to demonstrate customer empathy and build a connection with excellent customer diplomacy skills. - Problem solver, ability to multi-task, think creatively, and escalate issues and ideas to solve these issues. - Honesty and integrity. Competency - Excellent attendance and work record. - Ability to professionally articulate customer call scripts. - Exceptional customer service and active listening skills. - Ability to empathize and manage personal emotions. - Ability to function as an effective team member. - Ability to internalize and follow protocols/guidelines. - Demonstrate excellent oral and written communication skills; correct spelling is a must. - Strong time management skills and decision-making skills. - Strong computer skills required. - Must have a working knowledge of MS Office applications: Word, Excel, and Outlook. - Ability to be flexible with schedule (between hours of 6 am PST - 6 pm PST Monday through Friday, possible Saturday hours) and adapt to change.

Role Description ¿Tienes experiencia en ventas y te apasiona ayudar a las personas con soluciones? Esta es tu oportunidad para crecer en una de las compañías líderes en Call Center. - Experiencia mínima de 6 meses en áreas comerciales de call center (seguros o financiero) - Preferiblemente experiencia en venta de seguros (certificada) - Bachiller culminado - Actitud proactiva y orientación a resultados - Ganas de aprender y crecer profesionalmente Qualifications - Experiencia mínima de 6 meses en áreas comerciales de call center (seguros o financiero) - Preferiblemente experiencia en venta de seguros (certificada) - Bachiller culminado - Actitud proactiva y orientación a resultados - Ganas de aprender y crecer profesionalmente Requirements - Posibilidad de teletrabajo (según cumplimiento de indicadores) - Salario base: $1.750.905 + $249.095 auxilio de transporte - Comisiones SIN TECHO + prestaciones de ley - Comisiones promedio de $800.000 por cumplimiento de metas - Oportunidades reales de crecimiento profesional Benefits - Posibilidad de teletrabajo (según cumplimiento de indicadores) - Salario base: $1.750.905 + $249.095 auxilio de transporte - Comisiones SIN TECHO + prestaciones de ley - Comisiones promedio de $800.000 por cumplimiento de metas - Oportunidades reales de crecimiento profesional Company Description ¡Sé parte de INTELCIA y lleva tu carrera al siguiente nivel!