Member Services Supervisor

4 weeks ago

Alameda, United States ALAMEDA ALLIANCE FOR HEALTH Full time

**PRINCIPAL RESPONSIBILITIES**:
Under general direction from the Sr. Director, Member Services, the Member Services Supervisor is responsible for the day-to-day supervision of Member Services Representatives, collaborating with other department Supervisors and other department leadership members to meet and exceed performance targets. The Member Service Supervisor will primarily oversee Member Services Representative Tier I and Member Services Representative Tier II.

The Member Service Supervisor is responsible for ensuring member concerns are processed in a timely and accurate manner by communicating and enforcing department goals and objectives within a total quality management approach and compliance with all applicable state/federal regulations. The Member Services Supervisor will be responsible for the quality of the member services representatives’ daily work and activities, including but not limited to monitoring, developing, implementing, and evaluating the departmental call center operations to ensure optimal proficiency and effectiveness. The Supervisor will oversee assigned production and workflow systems, monitor, and enforce production and quality standards, ensure compliance with all operating policies and procedures, and collaborate with other departments to ensure the Alliance’s business, operating, and reporting goals are met. The Supervisor may occasionally function as a Member Service Representative in high call volumes or staffing shortages.

**PRINCIPAL RESPONSIBILITIES INCLUDE**:

- Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
- Oversees the process, management and reporting of the team's activities.
- Assists escalated callers as needed.
- Works with MS leadership to develop, implement and refine regular reporting metrics to measure productivity and process outcomes.
- Implements process improvements as identified and approved by MS leadership.
- Works cross functionally to review and revise policies and procedures to ensure National Committee for Quality Assurance (NCQA), Department of Managed Health Care (DMHC), Centers for Medicare & Medicaid Services (CMS) and Department Health Care Services (DHCS) regulatory compliance.
- Assists with developing, documenting, and updating regulatory and departmental compliance desktop/SOP policies and procedures.
- Builds, maintains and enhances relationships with AAH delegates, vendors, providers, health networks, community-based organizations and other key stakeholders.
- Maintains knowledge of current regulatory requirements and industry trends.
- Demonstrated knowledge of Medi-Cal benefits, Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) regulations.
- Superior communication skills and ability to effectively facilitate meetings and delivery.
- Supervise the daily operations of Call Center staff to ensure appropriate usage of resources to facilitate the Call Center process.
- Identifying the training needs includes assisting in the development of programs, training materials, job aids, orientation checklists, and competency checklists necessary to meet the educational and training needs of departmental staff.
- Develop tools and workflows to assist in the training and development of staff
- Responsible for maintaining any training materials to align with the current process to provide accurate and consistent plan benefit and service information to our members to meet regulatory requirements.
- Develop and conduct team training and education courses, including management education and training for new employees, ongoing staff, and cross-training of staff as needed.
- Develop and maintain complex audit processes and audit tools related to grievances, quality, compliance, and accurate data entry.
- Train staff to use audit tools and identify patterns or trends that require additional training or corrective action.
- Educate staff as necessary to ensure consistent performance and adherence to standards
- Audit staff in accordance with established auditing processes, work with the team to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management.
- Coach and train staff to identify the potential quality of care/service and accessibility concerns and refer to Grievance and Appeals (G&A), Case and Disease Management (CM/DM), Behavioral Health/ABA or Quality Improvement (QI).
- Identify opportunities for process improvements to facilitate department functions and ensure compliance with applicable governmental program guidelines.
- Identify system issues that fail to provide appropriate service to members or meet service expectations and make recommendations for improvement.
- Evalua

  • Member Services Representative I

    2 months ago

    Alameda, United States ALAMEDA ALLIANCE FOR HEALTH Full time

    **PRINCIPAL RESPONSIBILITIES**: Member Services Representatives are under the direction of a Member Services Supervisor, Manager and Director, and service our members through our call center as well assisting other departments with responses to member issues by initiating communication between departments to ensure action, cooperation, and compliance of...

  • Member Services Representative

    2 weeks ago

    Alameda, United States Planet Fitness Full time

    Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members, and guests. Essential Duties and Responsibilities •Greet members, prospective members, and guests, providing exceptional customer service. •Handle...

  • Member Services Representative

    1 week ago

    Alameda, United States Planet Fitness Full time

    Job Summary The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members, and guests. Essential Duties and Responsibilities •Greet members, prospective members, and guests, providing exceptional customer service. •Handle...

  • SLH Supervisor, Food Services

    1 week ago

    ALAMEDA, United States Alameda Health System Full time

    Summary SUMMARY: Under direction. Supervises the preparation, delivery and serving of food at San Leandro Hospital. Performs related duties as required. DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all...

  • Member Services Representative I

    2 weeks ago

    Alameda, United States Alameda Alliance Full time

    PRINCIPAL RESPONSIBILITIES: Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a...

  • Member Services Representative I

    3 weeks ago

    Alameda, United States Alameda Alliance for Health Full time

    DescriptionPRINCIPAL RESPONSIBILITIES: Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls...

  • Team Member: Service Champion

    2 weeks ago

    Alameda, United States Taco Bell Full time

    The minimum and maximum wage for this position is $20/hr!DRG is looking for energetic, enthusiastic individuals to join our team as Team Members! A Team Member is someone who enjoys people and is excited about working on a winning team! They come to work with a Positive, Can Do Attitude! Everyday!Diversified Restaurant Group is a people first company! We...

  • Bilingual Member Services Clerk

    3 weeks ago

    Alameda, United States A-Line Staffing Solutions Full time

    Now hiring a Bilingual Member Services Clerk in Alameda, CA. This administrative position requires candidates to be bilingual in English and Spanish and has career growth potential. This would be full time / 40 hours per week. NOT REMOTE- fully onsit Member Services, Member Service, Clerk, Bilingual, Spanish, Staffing, Retail

  • Team Members

    2 months ago

    Alameda, United States Michaels Stores, Inc. Full time

    Store - BAY-ALAMEDA, CA Deliver friendly customer service, help customers shop our store, and find what they’re looking for. Ensure all customers receive a fast and friendly checkout experience. Complete truck unloading and merchandise duties throughout the store including maintaining store recovery standards to deliver our Brand Promises. Help customers...

  • Team Member

    1 day ago

    Alameda, United States Michaels Stores, Inc. Full time

    Store - BAY-ALAMEDA, CA Deliver friendly customer service, help customers shop our store, and find what they’re looking for. Ensure all customers receive a fast and friendly checkout experience. Complete truck unloading and merchandise duties throughout the store including maintaining store recovery standards to deliver our Brand Promises. Help customers...

  • (Mandarin/Cantonese/Viet) Bilingual Member Services Representative

    4 weeks ago

    Alameda, United States A-Line Staffing Solutions Full time

    Job DescriptionJob DescriptionA-Line Staffing is now hiring Hybrid/WFH Bilingual Member Services Representatives in Alameda, CA. The Member Services Representative would be working for a Fortune 500 company and has career growth potential. This would be full time / 40+ hours per week.If you are interested in this Member Services Representative position,...

  • Security Officer Supervisor

    2 months ago

    Alameda, United States Surefox Full time

    Surefox is dedicated on being the leader in the physical risk management industry and the company of choice for military veterans searching for a career and culture that values their skills and expertise. Surefox North America Inc is a veteran-owned company that prides itself on creating a diverse and unique culture of trained and talented individuals. We...

  • Crew Member

    2 weeks ago

    Alameda, United States Round Table Pizza Full time

    **Crew Member** A Crew member is responsible for providing excellent guest service while executing operation and service standards of the Company. Depending on experience, availability and desire, a crew member will be trained in raw ingredient preparation, menu item preparation and guest service. You may be required to frequently stand, walk, reach with...

  • Team Member

    2 weeks ago

    Alameda, United States Jack In The Box Full time

    This job posting is for a position in a restaurant owned and operated by an independent franchisee, not Jack in the Box Inc. This means the independent franchisee, and not Jack in the Box Inc. will be your employer if you are hired. The independent franchisee is responsible for all employment related matters in the restaurant including, among other things,...

  • Member Experience Associate

    1 week ago

    Alameda, United States AAA Full time

    Member Experience Associate We call our club's vision, mission, values, and supporting pillars "Our House" because they are the foundation for all that we do. We're working to transform AAA for the next century with a mission to create Members for life by unleashing the innovative spirit of our Team Members. **Why Work For Us?** - Great Pay - opportunity...

  • Customer Service Representative

    3 weeks ago

    Alameda, United States Kelly Lux - State Farm Agent Full time

    Job DescriptionJob DescriptionBenefits:401(k)401(k) matchingHealth insuranceOpportunity for advancementPaid time offWellness resources State Farm Customer Service/Sales Combination Role Now Inviting Candidates to ApplyJoin a winning insurance and financial services team. Apply to become a State Farm Customer Service Representative responsible for taking care...

  • Customer Service Representative

    1 week ago

    Alameda, United States Kelly Lux - State Farm Agent Full time

    Job DescriptionJob DescriptionBenefits:401(k)401(k) matchingHealth insuranceOpportunity for advancementPaid time offWellness resources State Farm Customer Service/Sales Combination Role Now Inviting Candidates to ApplyJoin a winning insurance and financial services team. Apply to become a State Farm Customer Service Representative responsible for taking care...

  • AHD House Supervisor

    2 weeks ago

    Alameda, United States Alameda Health System Full time

    Summary SUMMARY: The AHD House Supervisor is responsible for providing clinical oversight and direction to the nursing staff during non-business hours. The AHD House Supervisor is skilled in problem solving and crisis intervention and serves as the first level contact for Administrative issues during non-business hours. The AHD House Supervisor has...

  • AHD House Supervisor

    2 weeks ago

    Alameda, United States Alameda Health System Full time

    Summary SUMMARY: The AHD House Supervisor is responsible for providing clinical oversight and direction to the nursing staff during non-business hours. The AHD House Supervisor is skilled in problem solving and crisis intervention and serves as the first level contact for Administrative issues during non-business hours. The AHD House Supervisor has...

  • AHD House Supervisor

    1 week ago

    Alameda, United States Alameda Health System Full time

    Summary SUMMARY: The AHD House Supervisor is responsible for providing clinical oversight and direction to the nursing staff during non-business hours. The AHD House Supervisor is skilled in problem solving and crisis intervention and serves as the first level contact for Administrative issues during non-business hours. The AHD House Supervisor has...