Member Relations Representative
1 week ago
We are a leading not-for-profit health maintenance organization dedicated to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.
We offer Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We're also committed to boosting the health of our community through outreach, education, and events.
Job SummaryWe are seeking a talented and enthusiastic Member Relations Representative to join our team. The successful candidate will promote a positive image of Jefferson Health Plans via telephone, utilizing each contact as an opportunity to educate callers about the plan, support resolution of Care Gaps through administrative support for the Care Coordination Program and retain members by providing high levels of service.
Key Responsibilities- Educate callers about Jefferson Health plan with the intent of retaining members and addressing gaps in care and supporting care coordination through appointment scheduling, transportation assistance, and referrals to care coordinators as necessary.
- Answer eligibility, benefits and provider inquiries, assuring that members receive service, use the plan correctly and gain a high level of satisfaction with the plan.
- Collaborate with internal departments to facilitate resolutions to member's issues and concerns.
- Respond to member and member-related calls in a courteous, professional & efficient manner providing timely follow-up to requests for information and service.
- Report on trends and issues which impact the membership.
- Conduct targeted telephonic outreach to members using a prepared script depending on Manager's direction.
- Enroll members in the Care Coordination Program as indicated by criteria.
- Open or build new cases in the care management system and route to the appropriate staff following the direction of the Team Leader or Manager.
- Research members' demographics and build cases in healthcare management system by: Calling hospitals, PCP offices, and/or home care agencies to locate a member's most recent phone number.
- Schedule and coordinate transportation needs.
- Identify and assist with care gaps.
- Document all care coordination activities in a member's case, per appropriate CCMS screens.
- Utilize the language line as indicated by the needs of the member.
- Refer members to the appropriate Nurse Advice lines and appropriate programs.
- Maintain accurate data entry into designated software systems.
- Promote excellent communication between Quality Management (QM), Utilization Management (UM), Care Coordination, Healthcare Economics and Special Needs Unit (SNU).
- Maintain call records, logs and other documentation in accordance with departmental requirements.
- Operate all applications and telephone systems effectively and efficiently, following established protocols for security, transfer and information exchange.
- Participate in appropriate staff meetings and training sessions, reporting on trends and issues which impact members and Health Partners as a whole.
- Attend monthly meetings as scheduled.
- Perform other clerical and support tasks as assigned.
- High School Diploma or GED required.
- Excellent communication and interpersonal skills required.
- 3-5 years customer service experience preferred.
- Managed care experience preferred.
- Excellent written and verbal communications skills.
- Bilingual a plus.
- Ability to work independent of direct supervision, but also must be able to work within a Team.
- Proficiency in Departmental Information Systems including DPW, Member Health Information System and Pharmacy Systems.
-
Member Relations Supervisor
3 days ago
Philadelphia, Pennsylvania, United States American Heritage Credit Union Full timeJob SummaryAmerican Heritage Credit Union is seeking a highly skilled Member Relations Supervisor to join our Contact Center team. As a key member of our team, you will be responsible for building and maintaining strong relationships with our members, providing exceptional customer service, and leading a team of Virtual Member Experience Advisors and...
-
Labor Relations Counsel
2 weeks ago
Philadelphia, Pennsylvania, United States Stealth Full timeThe Labor Relations Counsel will offer legal guidance and representation on issues pertaining to labor and employment legislation. The successful applicant will possess a robust background in labor relations, collective bargaining, and employment litigation. You will collaborate closely with various departments, labor unions, and other relevant parties to...
-
Public Relations Strategist
1 week ago
Philadelphia, Pennsylvania, United States Philadelphia College of Osteopathic Medicine Full timeJob Title: Public Relations ManagerJob Summary:The Philadelphia College of Osteopathic Medicine (PCOM) is seeking a highly skilled Public Relations Manager to join our Marketing and Communications team. As a key member of our team, you will be responsible for developing and implementing proactive strategies to promote PCOM's mission, research, programs, and...
-
Lead Employer Relations Manager
1 week ago
Philadelphia, Pennsylvania, United States The Board of Pensions of the Presbyterian Church Full timeDepartment: Plan Operations Office: Onsite Tuesday – Thursday; digital Monday and Friday The Lead Employer Relations Manager is accountable to the Manager of Employer Services, delivering daily operational support, account oversight, and comprehensive employer assistance to various organizations. This role involves interpreting and advocating for the...
-
Lead Client Relations Manager
2 weeks ago
Philadelphia, Pennsylvania, United States The Board of Pensions of the Presbyterian Church Full timeDepartment: Plan Operations Office: Onsite Tuesday – Thursday; digital Monday and Friday Location: Philadelphia, PA The Lead Client Relations Manager reports to the Manager, Employer Services, and provides daily operational support, account oversight, and comprehensive employer services to organizations. The Lead Client Relations Manager interprets and...
-
Philadelphia, Pennsylvania, United States American Heritage Credit Union Full timeJob SummaryAmerican Heritage Credit Union is seeking a Part-Time Member Experience Advisor to provide exceptional service to members, clients, and associates. This role involves proactively engaging with members to enhance their financial experience, rotating between lobby greeting, consultative member engagement, and processing transactions.Key...
-
Public Relations Manager
4 weeks ago
Philadelphia, Pennsylvania, United States The Philadelphia College of Osteopathic Medicine Full timePublic Relations ManagerWe are currently seeking to fill our Public Relations Manager position at the Philadelphia campus with a highly qualified and passionate individual.Job Title: Public Relations ManagerDepartment: Marketing & CommunicationsFLSA: ExemptLocation: Philadelphia, PA POSITION SUMMARYThe Public Relations Manager (non-supervisory) is...
-
Public Relations Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States Inkspirenize Full timeJob OverviewPosition Title: Communications RepresentativeDepartment: CommunicationsRole Summary: We are looking for a proactive and meticulous Communications Representative to enhance our communication efforts. This position entails supporting both internal and external communication initiatives, managing relationships with media, crafting compelling...
-
Member Service Representative
3 days ago
Philadelphia, Pennsylvania, United States TruMark Financial Full timeJob SummaryWe are seeking a highly skilled and motivated Member Service Representative to join our team at TruMark Financial Credit Union. As a key member of our Branch Operations team, you will be responsible for delivering exceptional member service and driving sales growth.Key ResponsibilitiesMember Service: Provide personalized service to members,...
-
Public Relations Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States Inkspirenize Full timeJob OverviewPosition Title: Communications RepresentativeCompany: InkspirenizeRole Summary: We are looking for an enthusiastic and meticulous Communications Representative to enhance our communication efforts. This position entails supporting both internal and external communication initiatives, fostering media relationships, crafting compelling content, and...
-
Public Relations Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States Inkspirenize Full timeJob OverviewPosition Title: Communications RepresentativeCompany: InkspirenizeRole Summary: We are looking for a proactive and meticulous Communications Representative to enhance our communication initiatives. This position is pivotal in executing both internal and external communication plans, fostering media relationships, crafting compelling content, and...
-
Client Relations Coordinator
1 week ago
Philadelphia, Pennsylvania, United States Sociaxe Full timeJob OverviewPosition: Front Desk RepresentativeCompany: SociaxeAbout Us:Sociaxe is an innovative digital marketing firm focused on social media strategy, brand enhancement, influencer partnerships, and content development. We enable brands to elevate their presence, connect with their audience, and achieve significant outcomes through creative and...
-
Client Relations Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States SI Busineess Solutions Full timeAbout Us:SI Business Solutions is dedicated to enhancing our partnerships with clients in the Telecom sector. We are expanding our team and looking for motivated individuals to join us.Position Overview:As a Customer Service Representative, you will play a vital role in maintaining and developing customer relationships. Our unique methodology focuses on...
-
Client Relations Coordinator
1 week ago
Philadelphia, Pennsylvania, United States Sociaxe Full timeJob OverviewPosition: Front Desk RepresentativeCompany: SociaxeAbout Sociaxe:Sociaxe is an innovative digital marketing firm focused on enhancing brand presence through social media management, brand strategy, influencer partnerships, and content development. Our mission is to help brands elevate their communication, connect with their audience, and achieve...
-
Customer Service Representative
3 days ago
Philadelphia, Pennsylvania, United States American Heritage Credit Union Full timeJob SummaryAmerican Heritage Credit Union is seeking a highly skilled Customer Service Representative to join our team at our Red Lion Road branch. As a key member of our team, you will be responsible for providing exceptional service to our members, clients, and associates, enhancing their overall experience.Key Responsibilities:Process account-related...
-
Client Relations Specialist
1 day ago
Philadelphia, Pennsylvania, United States RSP Events Full timeWe are seeking a highly skilled and experienced professional to join RSP Events as a Client Relations Representative. In this role, you will play a vital part in building and maintaining strong relationships with our retail clients, ensuring their marketing and promotional needs are met with excellence.Key Responsibilities: Client Relationship Management: ...
-
Membership Sales Representative
1 week ago
Philadelphia, Pennsylvania, United States City Fitness - Philadelphia Full timeAbout City Fitness - PhiladelphiaWe are a dynamic and growing fitness company in Philadelphia, dedicated to providing top-notch services to our members. As a Membership Sales Representative, you will play a crucial role in helping us achieve our goals.Job SummaryWe are seeking a highly motivated and results-driven individual to join our team as a Membership...
-
Head of Strategic Media Relations
2 weeks ago
Philadelphia, Pennsylvania, United States FIFA World Cup 26 Philadelphia™ Full timePosition Overview:The Head of Strategic Media Relations for FIFA World Cup 26 Philadelphia™ is responsible for overseeing the organization's communication strategies and media engagement. This role requires an in-depth understanding of the media environment and the ability to lead various agencies effectively while adhering to established budgets and...
-
Field Service Representative
2 days ago
Philadelphia, Pennsylvania, United States Medtronic Full timeJob SummaryWe are seeking a highly skilled and experienced Field Service Representative to join our team at Medtronic. As a Field Service Representative, you will be responsible for providing technical support and repair services to our customers in the Northern region of the US.Key ResponsibilitiesProvide Technical Support: Respond to customer inquiries and...
-
Head of Strategic Media Relations
2 weeks ago
Philadelphia, Pennsylvania, United States FIFA World Cup 26 Philadelphia™ Full timePosition Overview:The Head of Strategic Media Relations for FIFA World Cup 26 Philadelphia™ is responsible for navigating the complex media environment while demonstrating exceptional leadership capabilities to oversee various agencies on a daily basis. This role is pivotal in ensuring adherence to financial plans and schedules, acting as the primary media...