Job Description

The Manager, Member Services serves as the primary point person ensuring that business operations – including Enrollment, Call Center, Grievance and Appeals, and others, are working effectively to provide a high quality customer experience while meeting the requirements of the state contract.

Essential Functions:

• Support initiatives aimed at improving member experiences, retaining existing membership, and increasing enrollment.
• Continuous review and improvement of business process workflows.
• Lead Member Advisory Councils, including identifying appropriate locations, membership, and content, in order to provide meaningful and actionable member feedback.
• Utilize formal and informal meetings to gather information and provide feedback and developmental ideas to staff members.
• Evaluate, propose and develop ongoing and existing staffing and training needs.
• Review member communications and marketing materials and engage in outreach strategies including outbound telephone, email, print and other communication media to ensure adherence to all regulatory requirements.
• Liaise and collaborate with state officials, external partners and stakeholders, and internal business owners to manage communication and deliverables.
• Review inbound call information and training evaluations and recommend and implement solutions to strengthen all programs.
• Monitor grievance and appeals data and recommend and implement solutions to strengthen the program and mitigate member disenrollment.
• Analyze data and identify trends monthly to ensure company and state regulator expectations are met.
• Perform any other job duties as requested.

Education and Experience:

• Bachelor of Science/Arts in a Business related field or equivalent years of relevant work experience is required
• A minimum of three (3) years of health insurance, healthcare and/or managed care experience is required
• Previous leadership experience is required

Competencies, Knowledge and Skills:

• Proficiency in Microsoft Word, Excel, PowerPoint and Visio
• Strong data analysis and trending skills
• Strong team and staff development skills
• Strong collaboration and conflict resolution skill sets
• Proven leadership with the ability to build relationships/collaborate and influence at all levels
• Strong process and analytical skills with the ability to articulate and define outcome measures that capture key performance metrics
• Ability to work in a fast-paced environment
• Attention to detail
• Ability to develop, prioritize and accomplish goals/time management
• Strong decision making and problem solving skills
• Exceptional communication skills (both written and verbal) with the ability to present information in a variety of different formats to all levels
• Strong interpersonal skills and high level of professionalism
• Ability to work independently and within a team environment
• Effective active listening and critical thinking skills
• Display a customer service, member-focused orientation

Licensure and Certification:

• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Ability to travel as required by the needs of the business

Compensation Range:

$83,000.00 - $132,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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