Supervisor Member Services - Medicaid Market

Company :

Job Description : 

JOB SUMMARY

This job is responsible for supervising member service call center and ensuring timely, professional, and courteous responses to all customer inquiries and complaints, appropriately referring inquiries to other areas as necessary for resolution.  Investigate escalated member inquiries.  The incumbent may be required to make routine medical approval decisions.   

ESSENTIAL RESPONSIBILITIES

• Manage the departmental operations and day-to-day functions.
• Handle escalated calls from members, state agencies, providers and vendors.  
• Coach and counsel employees.
• Prepare reports for various internal and external areas for trends and statistics.
• Create and maintain quality and training programs for department.
• Responsible for on-call emergency contact for nights and weekend support.
• Other duties as assigned or requested.

QUALIFICATIONS Minimum

• High School Education or GED
• 1 year of experience in supervisory position
• 3 years of experience in customer service and/or health industry environment

Preferred

• Bachelor’s degree

Skills

• None

SCOPE OF RESPONSIBILITY   Does this role supervise/manage other employees?  

Yes         WORK ENVIRONMENT Is Travel Required?

No

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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