Call Center Operations Supervisor

MCS Puerto Rico; San Juan (PR); On-site; USD 40,000 - 60,000; Full time

Job summary

MCS Puerto Rico is seeking a Call Center Supervisor to oversee daily operations, ensure efficiency, and enforce CMS and other regulatory requirements.

The role focuses on managing staff, monitoring performance, handling escalations, and delivering timely responses to inquiries while maintaining service standards.

Strong leadership, attention to detail, and experience in health insurance environments are essential; bilingual Spanish/English preferred.

Qualifications

• Bachelor's degree in Business Administration or related fields.
• 1 year in customer service, call center, or similar.
• 1 year supervising staff.
• Health Insurance Industry experience preferred.
• Bilingual: Spanish and English, intermediate level.

Responsibilities

• Ensure compliance with policies, CMS/OIC regulations, and service standards.
• Investigate CTM and grievances; handle escalated cases with collaboration.
• Monitor calls from beneficiaries, insured individuals, and providers; identify improvements.
• Generate and analyze performance and quality reports.
• Monitor call center performance to meet SLAs.
• Assist in scheduling and resource allocation with Workforce Management.
• Ensure proper use of work tools and adherence to standards.
• Supervise and train staff to meet work plans and policies.
• Comply with all policies, laws, and industry regulations.
• Perform additional duties as assigned.

Skills

Staff supervision

Regulatory compliance

Call center operations

Performance monitoring

Education

Bachelor's degree in Business Administration

Associate’s degree or 60-64 credits

Job description

GENERAL DESCRIPTION: Responsible for overseeing the operations and performance of the Call Center team, ensuring efficiency, regulatory compliance, and adherence to company service standards, including the policies and procedures established by the Centers for Medicare and Medicaid Services (CMS) and other regulatory entities.

Regular Exempt GENERAL DESCRIPTION: Responsible for overseeing the operations and performance of the Call Center team, ensuring efficiency, regulatory compliance, and adherence to company service standards, including the policies and procedures established by the Centers for Medicare and Medicaid Services (CMS) and other regulatory entities.

ESSENTIAL FUNCTIONS:

• Ensures compliance with company policies and procedures, CMS and OIC regulations, and other applicable regulatory requirements by monitoring call volumes and workforce performance, and ensuring adherence to established service standards, working hours, and availability guidelines.
• Participates in the investigation of Complaint Tracking Module (CTM), grievance, and other escalated cases, effectively managing sensitive customer situations in collaboration with other departments and providing timely responses to internal inquiries.
• Ensures that calls from beneficiaries, insured individuals, and providers are actively monitored and recorded to identify areas for improvement and implement appropriate corrective actions to maintain consistent Call Center compliance.
• Generates, verifies, analyzes, discusses, and updates performance and quality reports used to measure call representatives’ results and overall Call Center effectiveness.
• Monitors Call Center performance metrics to ensure compliance with established performance guarantees and service level agreements (SLAs).
• Contributes to the planning and coordination of work schedules by ensuring optimal resource allocation throughout operating hours and supporting compliance with unit performance indicators in collaboration with Workforce Management.
• Ensures employees properly use and handle work tools in accordance with established service and quality standards.
• Supervises, monitors, trains, evaluates, and corrects personnel among others to comply with his/her role as a supervisor, to assure that his/her personnel fulfill their work plan and comply with their essential functions and that they behave following the policies, standards, norms, and procedures of the Company.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

Minimum Qualifications

Education and Experience: Bachelor's degree in Business Administration or related fields. At least one (1) year of experience performing duties in customer service, call center, or similar positions, preferably in the Health Insurance Industry. At least one (1) year of experience supervising staff.

OR

Education and Experience: Associate’s Degree or at least 60-64 college credits with at least three (3) years of experience performing duties in customer service, call center, or similar positions, preferably in the Health Insurance Industry. At least one (1) year of experience supervising staff.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: Not required. Other: Keyboard and telephone etiquette knowledge.

Languages: Spanish – Intermediate (comprehensive, writing and verbal) English – Intermediate (comprehensive, writing and verbal)

“We are an Equal Employment Opportunity Employer and take affirmative action to recruit protected veterans and individuals with disabilities.”