Manager of Member Services - Village Care

Manager of Member Services (Hybrid)

VillageCareMAX

112 Charles Street, New York, NY 10014

COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGECARE!

Under the supervision of Director of Business Operations, Manager of Member Services will oversee the coordination of Member Services staff scheduling, training, and day-to-day work flows to ensure that all requests and inquiries are processed timely. Communicates with Director of Business Operations and AVP of Member Experience and Support Services for any issues or concerns about, but not limited to, Operations. Assist members in accessing services, resolving issues and communicating with other members of the Interdisciplinary Care Team.

Some daily responsibilities will include:

• Responsible for overseeing that all in­coming calls are handled appropriately and in a timely manner.
• Ensures that there is appropriate Member Service coverage on the Phone Queue at all times.
• Ensures all shifts are covered with adequate Reps by language (Spanish, Cantonese or Mandarin).
• Oversees all faxes are processed timely to meet compliance.
• Facilitates meetings, coordinates the agenda, reviews and approves new workflows, maintains planning foresight and the work calendar.
• Assists members in arranging appointments with physicians and other health care provider services.
• Facilitates communication between members, subcontractors, providers and Care Managers.
• Communicated effectively with members with special needs by utilization mechanisms such as: interpretation vendor, TTYTele braille, large print/ braille, talking adaptive equipment, etc. Assists members with accessing translation services.
• Provides plan information to new members, family members or other representatives.
• Responds to non­clinical complaints; logs member and subcontractors' complaintsgrievances. Resolves same day complaintsgrievances where possible.
• Supervises hiring, ensuring effective training, ongoing monitoring and Quality Assurance, evaluations and any disciplinary actions of member services representatives. Responsible for assuring all new employees are trained.
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
• Oversees all work is completed in accordance with the confidentiality requirement mandated by HIPPA for member information including telephone service standards and turn-around times
• Any other projects assigned by Operations.

Education: Bachelor's Degree.

Experience:

• This position requires a minimum of 5 years job-related experience in healthcare HMO, Medicaid and Medicare experience is preferred.
• Strong ability to solve problems independently and interact with an integrated team.
• Strong multi-tasking abilities.
• Excellent interpersonal, verbal and written skills.
• Advanced Microsoft Outlook proficient in Microsoft Office such as Outlook, Word and Excel

Bilingual in Spanish, Russian, Creole, Chinese (Cantonese/Mandarin) is preferred.

There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you!

• PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life & Disability, Commuter Benefits, Paid Family Leave, Additional Employee Discounts

VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care.

VillageCare is an Equal Opportunity Employer.