✓You’ll need

Education

✓High school diploma or GED required

✓A Bachelor's degree in Business Administration, Health Administration, Marketing, or a related field may be substituted for four years of required experience

Bachelor’s degree in business administration, health administration, and marketing or related field preferred

Qualifications

✓6 years’ experience as a team leader or supervisor in Member Services, Claims Administration, Revenue Cycle, Financial Counseling or Provider Relations required

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About the role

Full time · Day We are searching for a Manager of Member Services -- someone who works well in a fast-paced setting. In this position, you will manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options. You will evaluate staff development, customer service results, and operational processes to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies. Think you’ve got what it takes? Job Duties & Responsibilities
Acts as an internal advocate for external customers, collaborating with other department managers to meet customers’ needs
Develops and implements training strategies that support the quality objectives and creates a continuous learning environment for professional growth
Ensures compliance with all regulatory (TDI, HIPAA, CMS, etc.) and accrediting (JCAHO, NCQA, etc.) requirements
Interviews, assesses, and selects candidates for hire
Participates in outreach activities designed to educate the community about available pediatric health plan options
Ensures that JCAHO and CAP requirements specific to your department are fulfilled but also understand the linkage between your department’s requirements and those of the integrated delivery system Skills & Requirements
High school diploma or GED required
Bachelor’s degree in business administration, health administration, and marketing or related field preferred
6 years’ experience as a team leader or supervisor in Member Services, Claims Administration, Revenue Cycle, Financial Counseling or Provider Relations required
A Bachelor's degree in Business Administration, Health Administration, Marketing, or a related field may be substituted for four years of required experience

Manager, Member Services

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About the role