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Supervisor, Member Care Division

Company: Integra Managed Care
Location: New Hyde Park
Posted on: December 6, 2019

Job Description:

Supervisor, Member Care Division, Lake SuccessGeneral Information Job Title:Supervisor, Member Care Division Location:1981 MARCUS AVE SUITE 100Lake Success, NY, 11042United States Employee Type:Full-Time Job Category:Member Care Division Contact information Name:Drew Baker Phone:347-505-3573 Email: Job DescriptionGeneral Purpose/Scope: The Supervisor, Member Care Division is responsible to ensure smooth day-to-day operations, optimize member care of the Member Care Division in accordance with Integra Managed Care policies and NYS regulatory requirements. This role is responsible for ensuring high standards of customer service and efficient coordination of member services, define and capture relevant performance metrics, and provide insight into operating performance for making recommendations for improvements. The supervisor is responsible for departmental activities, training, and performance management to advance the organization's customer service and member retention efforts and to ensure that all quality and compliance standards are met. Responsibilities Include: Monitors team performance and productivity to ensure quality, accuracy, and timely completion of tasks. Develops job performance standards and goals in accordance with Integra's customer service, member retention, and population growth targets. Assists in development of functional workflows, training materials, and best practices to ensure optimal departmental performance. Monitors performance and productivity through reviews, audits, and reports and provides direct and timely feedback to employees, identifying opportunities for improvement and staff education and training. Provides departmental oversight to ensure all written and verbal correspondence is completed within designated time frames and that appropriate authorizations are in place for member services. Provides Coordinators with performance feedback and ongoing education, mentoring, and cross-training. Performs disciplinary actions and develops corrective action plans for team members and team leads as needed. Completes performance reviews, identifies group and individual improvement needs, and assists with development of continuing education and training programs to improve staff competency. Assist with payroll process for Member Care Division Exercises independent judgment to identify and resolve problems in a timely manner. Gather and analyze information skillfully and maintain confidentiality. Establishes and maintains production and quality standards by developing and ensuring compliance with all customer service and process standards through reviews, technical and quality monitoring audits, reports and practices. Provides direct and timely feedback to all staff on the results Understands requirements for Medicaid eligibility and processes in Managed Long-Term Care as well as Medicare Provides oversight of administrative support to the Care Mangers and other members of the team Ensures representatives follow up with providers to ensure quality of service for in-home services that are part of members service plan Monitors the ongoing provision of services for the member Ensures member requests for information and member materials are handled in a timely manner Provides oversight to ensure MD Orders, Rx's and other documentation necessary from members PCP are obtained to ensure good quality service Qualifications: High school diploma, Bachelor's Degree preferred Minimum 3-year supervisory experience in health care setting Knowledge of Medicaid eligibility requirements and MLTC processes and regulatory requirements Skills: Proficient in Word, Excel, Power Point. Strong ability to lead teams and mobilize resources Ability to interface with all levels of staff, members, and community contacts/vendors Must possess excellent strong written, verbal, and interpersonal communication skills. Demonstrates analytical and organizational skills, experience working under deadlines, and strong understanding of project management from start to finish Must have demonstrated ability to manage multiple projects and priorities at the same time. Knowledge of administrative and management practices Knowledge of research techniques, methods, and procedures Knowledge of presentation requirements and methods Ability to analyze problems, identify alternative solutions, project consequences of proposed actions, and implement recommendations in support of goals Licenses/Certifications: N/A Integra is an Equal Opportunity Employer and prohibits discrimination or harassment based on any characteristics protected by the laws or regulations in the locations where we operate. If this opportunity sounds exciting and challenging to you, please apply.PandoLogic. Keywords: Customer Service Representative, Location: New Hyde Park, NY - 11042

Keywords: Integra Managed Care, New York , Supervisor, Member Care Division, Other , New Hyde Park, New York

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