Supervisor(a) de Operaciones del Centro de Llamadas

MCS Health; San Juan (PR); On-site; USD 42,000 - 64,000; Full time

Job summary

MCS Healthcare Holdings, LLC is seeking a Call Center Supervisor to oversee operations, ensure CMS compliance, and drive performance across the Call Center team in Puerto Rico. The role requires monitoring of service levels, staff scheduling, and handling escalated cases with cross‑department collaboration.

The ideal candidate has a Bachelor’s or an Associate’s degree with relevant experience in health insurance call center environments, and strong leadership and communication skills in English

Qualifications

• Bachelor’s degree in Business Administration or related field.
• At least 1 year of experience in customer service or call center roles.
• At least 1 year of experience supervising staff.
• Proven experience may be replaced by previously established requirements.
• Certifications/licenses not required.
• Keyboard and telephone etiquette knowledge.

Responsibilities

• Oversee operations and performance of the Call Center team to meet service standards.
• Monitor regulatory compliance with CMS, OIC, and other applicable requirements.
• Investigate CTM, grievances, and escalated cases and provide timely responses.
• Monitor calls from beneficiaries, insured individuals, and providers for compliance and improvement.
• Generate and analyze performance and quality reports for Call Center metrics.
• Ensure staffing and scheduling align with SLAs and workload.
• Train, supervise, evaluate, and coach staff to meet targets and policies.
• Comply with all company policies and relevant laws and regulations.

Skills

Spanish (Interm)

English (Interm)

Customer service

Supervisory skills

Education

Bachelor’s degree in Business Administration or related field

Associate’s degree / 60-64 credits + 3+ years experience

Job description

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 Aff…

MCS Healthcare Holdings, LLC. (MCS)is an Equal Employment Opportunity Employer and take Aff… MCS is a participating E-Verify employer.