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Member Services Team Leader - Maumee, United States - ProMedica
Description
**Job Details**
**Member Services Team Leader - Member Services - Full Time **
This details all the information about the job posting. Share this job as a link in your status update to LinkedIn. ****
Job Title Member Services Team Leader - Member Services - Full Time Category Management / Supervisory Organizational Unit ProMedica -> Paramount -> Paramount Care, Inc. -> Member Services Location Maumee, OH 43537 US (Primary)
Job Description At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA the National Committee for Quality Assurance for our Ohio HMO, Elite and Advantage products. Were also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest. For more information about Paramount, please visit our website
**Position Summary**
Assume responsibility and oversight of Member Services day to day operations to ensure continued membership retention, growth and education by providing quality professional personalized service to all internal and external customers.
**Accountabilities**
1. Supervise all Member Service Representatives in day to day operations to ensure plan personnel policies and individual quality indicators are consistently being administered.
2. Provide annual performance appraisals for direct reports along with documented counseling/disciplinary procedures.
3. Develop and maintain all policies and procedures for the Member Service Department, including quality assurance goals, to ensure regulatory requirements and departmental standards are being met.
4. Maintain complete, current records of all Member Service statistics and provide monthly reporting to the Member Service Director.
5. Monitor telephone reporting systems and evaluate processes to ensure adequate staffing of department to meet regulatory requirements as well as meet and exceed customer expectations.
6. Provide resource consultation and answer (internal and external) inquiries as needed to meet departmental goals while maintaining responsibility for handling sensitive inquiries.
7. Coordinate bi-monthly team meetings, department staff meetings and quarterly one on one meetings with individual staff.
8. Participate in Paramount multi-disciplinary teams to achieve improvement in processes resulting in an increase in customer service for both internal and external customers.
9. Improve employee satisfaction and retention through promotion and participation in department initiatives to identify concerns and assist in the implementation and evaluation of action plans.
10. Support opportunities for personal growth and education through participation in continuing education and encouragement of staff participation.
11. Provide recommendations in the selection of new associates through participation in the interview process of applicants for positions in Member Services.
12. Assist in training and education to ensure staff effectiveness and member satisfaction.
13. Perform other duties as directed.
Job Requirements
Education: Associate's degree in health care administration (or related field) or 7+ years relevant experience.
Experience handling Paramount member inquiries (with demonstrated thorough knowledge of all product lines, claims and enrollment procedures) required.
Excellent written, verbal & interpersonal communication skills required.
Ability to work independently and plan/coordinate/organize multiple priorities.
Ability to communicate on telephone and move between company work stations/departments; ability to operate general office equipment, including computers.
Years of Experience: 2 years customer service experience in a managed care, Medicaid or other health-related organization required. 3 to 5 years of experience in a leadership position required.
**Preferred Qualifications**
Education: Bachelors degree preferred.
Years of Experience: Supervisory, managerial experience strongly preferred.
***ProMedica** is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit*
*Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category**. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact* **
*Equal Opportunity Employer/Drug-Free Workplace*
Employee Exemption Type Exempt Job Type Full Time Budgeted Hours / Pay Period 80 Shift Type Shift Hours Weekends On-call Requirements Additional Schedule Details
