Manager, Member Services

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

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