-
Team Leader Member Relations
3 weeks ago
Jefferson Health Plans Harrisburg, United StatesWhy Choose Jefferson Health Plans? · We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are c ...
-
Supervisor Member Relations
3 weeks ago
Health Partners Plans Inc Harrisburg, United StatesWhy Choose Health Partners Plans? Health Partners Plans is an award-winning, not-for-profit health maintenance organization serving more than 280,000 members for more than 30 years. Health Partners Plans has been doing it right and improving health and wellness in communities thr ...
-
Occupational Therapist
2 weeks ago
Austill's Educational Therapy Services Harrisburg, PA, United StatesAustill's Educational Services, the leading provider of school-based related services in southeastern PA, is actively seeking a pediatric Occupational Therapist to work 2-3 days per week with school age children in the Harrisburg, PA area. This opportunity will start with the sum ...
-
Indirect Loan Processor
3 weeks ago
PSECU Harrisburg, United States Full timeDUTIES AND ACCOUNTABILITIES - Essential for this position: · Verify documentation for completeness by indirect program participants including third-party refinance companies and other vendors. · Follows up with dealerships, members, and other necessary individuals to acquire req ...
-
FEP Performance Analyst
1 week ago
Capital Blue Cross Harrisburg, United States Full timePosition Description · This position is responsible for the audit functions related to determining and validating Plan performance, as it relates to Membership, Claims and Customer Service activity. This is accomplished through accordance with established policies, internal pro ...
-
Senior Meat Cutter
1 week ago
Sam's Club Harrisburg, United States Full timePosition Summary... · As a Senior Meat Cutter you will drive sales in your area to deliver to our members more of what they love, for less. You will work collaboratively with other associates to ensure the total club meets the member's expectations. What you'll do... · Be a T ...
-
Operations Manager
3 weeks ago
Builders FirstSource Harrisburg, United StatesPURPOSE · Under the general direction of the General Manager, manages multiple operations that control the flow of materials both to and from the location in the most timely, productive and cost effective method possible. Examples of these operations would be manufacturing, dist ...
-
Sales and Marketing Project Coordinator
1 week ago
Classical Academic Press Harrisburg, United StatesClassical Academic Press (CAP) is in search of a full time Sales and Marketing Project Coordinator with 2-3 years prior experience. CAP is a faith-based owned and operated company. It is a fast-growing publisher of curricula and media for classical schools, Christian schools, cla ...
-
Bakery Store Manager
3 weeks ago
Gecko Hospitality Harrisburg, United StatesBakery Store Manager · Bakery/Café/Retail · Salary Up to $50,000 (DOE) · Are you a Store Manager that is looking to work with a company that is full of passion, encouragement, hard work and career growth? If you are, then this is the perfect opportunity for you to bring your tale ...
-
Director, Enterprise Project Management
1 week ago
Jefferson Health Plans Harrisburg, United StatesWhy Choose Jefferson Health Plans? · We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are c ...
-
Sr. Licensed Practical Nurse
2 weeks ago
UPMC Life Changing Medicine Harrisburg, United States Full timePlease note this is a rotating Day/Night Shift position. · Main 5 is a 29-bed acute care medical unit that is dedicated to providing high quality compassionate care to a diverse adult and geriatric patient population. The majority of patients come to Main 5 through the Emergency ...
-
BCBA Clinical Manager
2 days ago
NeurAbilities Healthcare Harrisburg, United StatesJoin a team striving to be better, do better, and which empowers others to live a better life. · Be a BCBA Clinical Manager with our Harrisburg team, serving children in areas which may include Harrisburg and York. BCBA Clinical Managers earn a competitive salary, have opportuni ...
-
General Manager
6 days ago
Trulieve Harrisburg, United StatesJob Title: General Manager · Department: Retail · Reports To: Area Manager · FLSA Status: Regular-Exempt · ROLE SUMMARY · The General Manager will be responsible for managing personnel, inventory purchasing and tracking, sales goals and bonus targets, as well as the general day ...
-
Manager Central Sterile Processing
3 weeks ago
UPMC Life Changing Medicine Harrisburg, United States Full timeThe Manager of Central Sterile Processing is responsible for all medical/surgical sterile and supply related functions. The responsibility entails operations and quality of service provided, employee development, operating and capital budget accountability and short/long-term pla ...
-
Floater Pharmacist
3 weeks ago
The GIANT Company Harrisburg, United StatesAddress: USA-PA-Harrisburg-2300 Linglestown Road · Store Code: GC - Store Mgrs · At The GIANT Company we're committed to making our stores and facilities better every day for our team members, customers, and communities. It's our secret recipe for success and it guides everyt ...
-
Corporate Re-engineering Intern
3 weeks ago
Capital Blue Cross Harrisburg, United States Full timePosition Description · At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA." · Capital Blue Cross has an exciti ...
-
Software Process Engineer
1 day ago
Cloudinity Inc Harrisburg, United StatesSoftware Process Engineer · Remote but need to go onsite to pick up equipment · Harrisburg, PA · Direct client · Need local to PA or nearer to PA · **Job Summary:** · We are seeking a Software Process Engineer to implement and support standard software engineering processes for ...
-
Assistant Food Service Director
2 weeks ago
Spring Creek Rehabilitation and Nursing Center Harrisburg, United StatesAssistant Food Service Director · *NO COVID VACCINATION REQUIREMENT* *MASKS OPTIONAL* · Location: 1205 S 28th St, Harrisburg, PA 17111 · Spring Creek currently has a great opportunity for an Assistant Food Services Director We are looking for compassionate and enthusiastic cand ...
-
Quality Assurance Analyst
3 weeks ago
D&H Distributing Harrisburg, United StatesSUMMARY · The QA Analyst role will test relevant focus area processes and business flow by processing a variety of test cases through focus area core and custom screens. Test activities specific to focus area processes will be utilized. Responsibilities include assisting with te ...
-
Hospice Licensed Practical Nurse
3 weeks ago
Morning Star Hospice and Palliative Care Solutions Harrisburg, United States Full timeWe believe working in hospice is a calling. At Morning Star Hospice and Palliative Care Solutions, our goal is to provide the highest quality care through compassionate, holistic care to our patients and families. We are committed to promoting team member satisfaction by supporti ...
Team Leader Member Relations - Harrisburg, United States - Health Partners Plans Inc
1 month ago
Description
Why Choose Jefferson Health Plans?We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members.
We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.
While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.
Perks of JHP and why you will love it here:Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
Flextime and Work-at-Home Options
Impact on the communities we service
We are seeking a talented and enthusiastic Team Leader, Member Relations to join our team
General Description:
This position reports to the Member Relations Manager. The team leader works with minimal direction in coordination with the Member Relations Supervisor and Management.
Responsibilities include but are not limited to responding to complex external and internal inquiries in a professional, informative, and courteous manner (10-15% on the phone).
This role requires mastering and demonstrating skills and concepts within the call center environment.Demonstrates the ability to think outside of the box to identify, resolve, and assist the team with the handling of complex inquiries.
Support and represent the Member Relations team. Assist in formulating department guidelines, coordinate projects and assist with staff training when needed.As the Team Leader, Member Relations, your daily duties may include:
Directs staff in performance according to standards of practice, state and federal regulations, accreditation agencies and company policies and procedures.
Serves as the point person/technical resource for issues regarding all lines of business.Anticipate and identify causes of interruption in unit functions and takes appropriate action to meet performance expectations.
Develop, among staff, a consciousness for the need for teamwork to attain departmental objectives. As well as direct staff in a constructive and positive manner to foster positive employee relationships.
Recommend candidates for hire to the Manager based on subjective and objective findings identified by using a standardized interviewing tool.
Ensures that reports are completed, accurate, and timely to meet regulatory and company regulations.Attend and assume a leadership role in Team meetings, staff meetings, and all external cross-functional meetings.
Attends external meetings as representative of Health Partners Plans and represent department at meetings which have an impact on Call Center operations and reports on the same.
Assist Member Relations Representative with accurate benefit information for callers.Assist in the coordination of special assignments including reports and departmental projects.
Provide phone coverage on high call volume days to provide telephone support as required and handle calls which escalate beyond the Member Relations Representatives abilities.
Act as a liaison to member's who request one-on-one assistance.Member Relations Macess Inventory Oversight.
Responsible for the documentation of operating procedures.
Collaborate with leadership and support team to set up touch point meetings with an agenda. Provide recommendations and feedback based off team performance.
Tracking/Trending of call volumes and escalated matters, reporting on trends and issues that impact the Member Relations Department.
Coordinate cross-functional and interdepartmental initiatives.
Schedule and assist with the facilitation of team meetings, and huddles.
Adhere to the following turn-around times for issue resolutions via e-mail, Macess, in-person, etc.
Follow Department guidelines on response time and resolution (acknowledgement) for standard inquiries and, expedited issues.
Evaluate staff quality performance utilizing coaching tools as a resource for improvement.
Mentoring staff using intense one on one coaching sessions as a means of performance enhancement.
Facilitate mini group and individual training sessions to support staff with knowledge gaps to perform across functional discipline.
Review staff's monthly audit appeals for accuracy and appropriateness of submission.
Provide supervision and support to Call Center staff, including participating in the monthly.
On Call rotation cycles which provides 24/7 support.
Attend SQC and Fair Hearing meetings to provide interpretation and feedback as needed.
Other duties as assigned.
Qualifications
High School Diploma or equivalent work experience.
3-5 years progressive customer service experience across multiple disciplines preferred.
Skills, We Value:
Excellent written and verbal communications skills.
Bilingual a plus, but not necessary.
Ability to work independent of direct supervision, but also must be able to work within a team.
Proficiency in Departmental Information Systems including DPW, Member Health Information System and Pharmacy Systems.
#J-18808-Ljbffr