Supervisor - Member Services Supervisor

3 weeks ago

Chula Vista, United States Community Health Group Full time

Job Description

Job Description

POSITION SUMMARY Supervises the daily activities of Member Services Specialists (MSS) and coordinates daily operations. Acts as liaison between membership, provider, CHG management, and staff on issues related to member representation.

Works closely with staff to maintain performance benchmarks within acceptable guidelines.

COMPLIANCE WITH REGULATIONS: Works closely with all departments necessary to ensure that the processes, programs, and services are accomplished in a timely and efficient manner by CHG policies and procedures and in compliance with applicable state and federal regulations including CMS and/or Medicare Part D and Special Needs Plan (SNP).

RESPONSIBILITIES Oversees and monitors the department’s daily operations.

Trains new employees and conducts regular in-service training for current staff on how to provide accurate information to members and the community.

Works to ensure compliance with all regulatory requirements including those from DHCS and CMS.

Evaluates employee performance and works with the Manager to counsel staff when there are performance problems or issues.

Prepares and motivates the (MSSs) as they implement outreach and enrollment activities.

Responds to non-routine and difficult situations when the MSSs need assistance.

Runs, analyzes, and submits a variety of statistical and activity reports to the Manager every month.

Provides coaching and support to the MSSs, including assisting in difficult situations or issues and working with the member reassignment process.

Participating in continuous quality improvement activities including live call and recorded call monitoring to ensure the accuracy of information and the quality of customer service provided by the MSSs.

Resolve customer service issues by working with MSSs to identify internal and external operational issues preventing the delivery of good customer submitting recommendations for resolution.

Coordinate department training by assessing department training needs and assists in developing training curriculum.

Maintains schedules by coordinating work and vacation schedules for MSSs to ensure adequate coverage at all times, reviewing time cards and ensuring timely and appropriate

completion/submission.

Monitors member reimbursements by reviewing staff requests for member reimbursement and recommends action.

Controls performance benchmarks and timelines by monitoring telephone call traffic and working with staff to maintain telephone abandonment rate and other departmental performance benchmarks within acceptable guidelines.

Maintains product and company reputation and contributes to the team effort by conveying a professional image and accomplishing related tasks; participating on committees and in meetings; performing other duties as assigned or requested.

EDUCATION BA degree.

In healthcare-related fields preferred.

EXPERIENCE/ SKILLS Two (2) years of experience in public assistance, human or health services programs, and a minimum of one (1) year of experience supervising the work of others.

Experience with and sensitivity to cultural background and linguistic needs of membership.

Familiarity and respect for special social needs of the Medi-Cal population.

Knowledge of Medi-Cal program eligibility requirements and familiarity with services available through community-based, ethnic service, and advocacy organizations throughout San Diego.

Proficient in the use of PCs and Microsoft Office Suite. including proficiency in MS Word and Excel required, PowerPoint preferred.

Some knowledge of County Social Services programs and Social Security Administration programs.

Bilingual capabilities in English/Spanish or appropriate threshold language.

Excellent communication and interpersonal skills.

Ability to exercise mature and independent judgment.

PHYSICAL REQUIREMENTS Prolonged periods of sitting.

Extensive telephone use may be required.

May be required to work evenings and/or on weekends.

Company Description Community Health Group (CHG) is a locally-based nonprofit health plan serving more than 360,000+ members in San Diego County. For 38 years CHG has been dedicated to coordinating quality care and providing exceptional customer service. Our more than 300 committed and well-trained employees do this as stewards of government funds from health-related programs (Medi-Cal and Cal MediConnect) designed to protect the most vulnerable people in our society. Providing access to culturally sensitive, quality care for our members is at the heart of what we do each and every day.

Company Description

Community Health Group (CHG) is a locally-based nonprofit health plan serving more than 360,000+ members in San Diego County. For 38 years CHG has been dedicated to coordinating quality care and providing exceptional customer service. Our more than 300 committed and well-trained employees do this as stewards of government funds from health-related programs (Medi-Cal and Cal MediConnect) designed to protect the most vulnerable people in our society. Providing access to culturally sensitive, quality care for our members is at the heart of what we do each and every day. #J-18808-Ljbffr

  • Licensed Clinical Supervisor

    3 weeks ago

    Chula Vista, United States South Bay Community Services Chula Vista Full time

    Under the supervision of the Clinical Director, the Clinical Supervisor shall be responsible for ensuring the quality of client care by supporting the use of a trauma informed approach by staff, students and volunteers which aligns with the agencys Supervisor, Clinical, Clinical Director, Licensed, Clinic, Program Director, Healthcare

  • Floor supervisor

    4 weeks ago

    Chula Vista, United States Aunt Emmas Pancakes Full time

    Job DescriptionJob DescriptionWe are seeking a motivated and experienced Floor Supervisor to join our team. The Floor Supervisor will be responsible for overseeing and coordinating the activities of our floor staff to ensure efficient and exceptional customer service. This role plays a crucial part in maintaining a positive customer experience and...

  • Area Supervisor>

    3 weeks ago

    Chula Vista, United States DDS DISCOUNTS Full time

    dd's Discounts - 1325 3rd Avenue [Store Supervisor / Department Manager] As an Area Supervisor at dd's Discounts, you'll: Understand that safety is the number one priority and practices safe behaviors in everything they do; Maintain a high level of awareness on the sales floor to create a safe and secure shopping environment for everyone; Treat all Customers...

  • Road Supervisor

    2 days ago

    Chula Vista, United States Transdev Full time

    **About Transdev**: Cities, counties, airports, companies, and universities across the U.S. contract with Transdev to operate their transportation systems, maintain their vehicles and fleets, and deliver on mobility solutions. Transdev U.S. employs a team of 32,000 across 400 locations while maintaining more than 17,000 vehicles. Part of a global company,...

  • Supervisor - Facilities Supervisor

    2 weeks ago

    Chula Vista, United States Community Health Group Full time

    Job DescriptionJob DescriptionPOSITION SUMMARYUnder the general supervision of the Facilities Manager or CFO performs activities required to maintain the building and grounds in clean and orderly condition.  RESPONSIBILITIESMonitors the appearance of the building exterior and interior by performing a daily inspection walk-through.  Assists in the cleaning...

  • Psychoanalytic Psychotherapy Supervisor

    3 weeks ago

    Chula Vista, United States Ladgov Corporation Full time

    JOB TITLE : Psychoanalytic Psychotherapy SupervisorLOCATION : Navy Medical Center, Psychiatry, San Diego, CADUTIES :Provide postgraduate year-3 and postgraduate year-4 psychiatry residents psychoanalytic psychotherapy case supervision.Formal didactic instruction in psychoanalytic psychotherapy, to include the integration of psychoanalytical concepts in case...

  • Psychoanalytic Psychotherapy Supervisor

    4 weeks ago

    Chula Vista, United States Ladgov Corporation Full time

    Job DescriptionJob DescriptionJOB TITLE : Psychoanalytic Psychotherapy SupervisorLOCATION : Navy Medical Center, Psychiatry, San Diego, CADUTIES :Provide postgraduate year-3 and postgraduate year-4 psychiatry residents psychoanalytic psychotherapy case supervision.Formal didactic instruction in psychoanalytic psychotherapy, to include the integration of...

  • Member Service Representative

    1 month ago

    Chula Vista, California, United States Navy Federal Credit Union Full time

    Overview To provide members and prospective members the full range of products and services offered by Navy Federal Credit Union including depository accounts such as checking, savings, certificate IRA, revocable trust and estate accounts; Lending products; and credit/debit cards. To perform moderately complex platform banking functions under supervision....

  • Clinical Supervisor

    3 days ago

    Vista, United States Britech Group, Inc Full time

    Job DescriptionJob DescriptionUnder the direction of the Program Manager, clinical TBS supervisors are responsible for the coordination and approval of clinical services of the Therapeutic Behavioral Services coaches, overseeing coaches to deliver appropriate and ethical mental health services and interventions in accordance with county contracts, targeted...

  • TBS Supervisor

    3 weeks ago

    Vista, United States New Haven Youth Full time

    Job DescriptionJob DescriptionSUMMARY: Under the direction of the Program Manager, supervisors are responsible for the coordination and approval of clinical services of the Therapeutic Behavioral Services coaches, overseeing coaches to deliver appropriate and ethical mental health services and interventions in accordance with county contracts, targeted goals...

  • TBS Supervisor

    3 weeks ago

    Vista, United States New Haven Youth Full time

    Job DescriptionJob DescriptionSUMMARY: Under the direction of the Program Manager, supervisors are responsible for the coordination and approval of clinical services of the Therapeutic Behavioral Services coaches, overseeing coaches to deliver appropriate and ethical mental health services and interventions in accordance with county contracts, targeted goals...

  • Front Desk Supervisor

    2 weeks ago

    La Vista, United States Atrium Hospitality Full time

    Hotel: La Vista Embassy Suites. Front Desk Supervisor. Full time. Atrium SPIRIT where teamwork, passion and appreciation ignite service excellence Get To Know Us: The La Vista Embassy Suites & Conference Center, located in La Vista, Nebraska, just Front Desk, Supervisor, Customer Service, Hotel, Guest Experience

  • Front Desk Supervisor

    2 weeks ago

    La Vista, United States Atrium Hospitality Full time

    Hotel: La Vista Courtyard. Front Desk Supervisor. Full time. Atrium SPIRIT where teamwork, passion and appreciation ignite service excellence Job Description. Get To Know Us:The La Vista Courtyard by Marriott, located in La Vista, Nebraska, just of Front Desk, Supervisor, Customer Service, Hospitality, Hotel, Guest Experience

  • Operations Supervisor

    3 weeks ago

    Sierra Vista, United States Global Medical Response Inc Full time

    IMMEDIATE HIRING! OPERATIONS SUPERVISOR Full-Time Opportunity!! We're hiring an Operations Supervisor who is responsible for overseeing day-to-day operations which may include staffing, scheduling, ensuring maintenance of equipment and supplies, internal communications, budgetary considerations, outside agency interface, and community relations. ...

  • Operations Supervisor

    1 day ago

    Sierra Vista, United States Global Medical Response Inc Full time

    IMMEDIATE HIRING! OPERATIONS SUPERVISOR Full-Time Opportunity!! We're hiring an Operations Supervisor who is responsible for overseeing day-to-day operations which may include staffing, scheduling, ensuring maintenance of equipment and supplies, internal communications, budgetary considerations, outside agency interface, and community relations. ...

  • Member Service Representative

    1 week ago

    Chula Vista, United States Navy Federal Credit Union Full time

    Overview To provide members and prospective members the full range of products and services offered by Navy Federal Credit Union including depository accounts such as checking, savings, certificate IRA, revocable trust and estate accounts; lending products; and credit/debit cards. To perform advanced platform banking functions with minimal supervision....

  • TBS Clinical Supervisor

    1 month ago

    Vista, United States New Haven Youth Full time

    Job DescriptionJob DescriptionSUMMARY: Under the direction of the Program Manager, supervisors are responsible for the coordination and approval of clinical services of the Therapeutic Behavioral Services coaches, overseeing coaches to deliver appropriate and ethical mental health services and interventions in accordance with county contracts, targeted goals...

  • Operations Supervisor

    4 hours ago

    Vista, United States Living Spaces Full time

    Position Summary The primary role of the Operations Supervisor is to oversee every aspect of Operations, through Standard Work and the Operations GEM Model. The Operations Supervisor will oversee a team of Operations Leads to achieve success in all customer interactions and transactions with a Guest-First mentality. Position Description Essential Duties...

  • Crew Member

    3 days ago

    Chula Vista, United States San Diego Kabob Shack Full time

    Job DescriptionJob DescriptionSan Diego Kabob Shack, a quick-service restaurant, in Chula Vista seeks additional team members to work in a fast-paced but fun environment. We are seeking cashiers who have excellent customer service skills and can help kitchen staff with food preparation. We are looking for someone who is eager to learn, a team player, and...

  • Lab Supervisor

    2 days ago

    Sierra Vista, AZ, United States Radius Staffing Solutions Full time

    Lab Supervisor Opportunity in Arizona - Apply Now! Are you an experienced Lab Professional seeking a new opportunity in the Sierra Vista, Arizona area? Look no further! A reputable healthcare facility is currently seeking a Lab Supervisor to join their team. Job Description: As a Lab Supervisor, you will be under the immediate supervision of the Laboratory...