Job Information
Cambia Health Solutions Manager Group Member Services in Spokane, Washington
Manager Group Member Services (HEALTHCARE) Work from home (telecommute) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Payment Integrity - Support Services Team is living our mission to make health care easier and lives better. The Manager Member Operations is responsible for leading the development and implementation of business operations and member service strategies that align with the organization's goals and objectives. This role will oversee the management of multiple teams, that may include ASO Operations, Customer Service, and Member Operations Support, to ensure that all key service-related performance metrics are met. The Manager will also be responsible for ensuring that all performance metrics and contract obligations are met, and that the organization is in compliance with regulatory requirements - all in service of making our members' health journeys easier. If you're a motivated and experienced Manager or Supervisor in Group Services, Customer Services (HC), Membership, etc. looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Qualifications and Certifications: * Bachelor's degree in a business or healthcare administration field * 8+ years of experience in business operations or customer service leadership or supervisory position with increasing levels of responsibility * Or equivalent combination of education and experience. Skills and Attributes (Not limited to): * Demonstrated good judgment, problem-solving, analytical, and cognitive, verbal, and written communication and formal presentation skills * Ability to apply critical thinking and sound judgment * Current operational knowledge of the insurance field preferred * Advanced knowledge of program evaluation concepts and methodologies, with expertise in program effectiveness analysis, measurement, and reporting * Excellent working knowledge of MS Office products * Understanding of regulatory constraints associated with publishing benefit documents, MTM requirements, and dependencies of CAPS What You Will Do at Cambia (Not limited to): * Develop and implement business operations and member service strategies that align with the organization's goals and objectives * Oversee the management of multiple teams, including ASO Operations and Group and Member Operations Support * Good understanding of member service functions, including experience in managing high volume production environments. * Ensure that all key service-related performance metrics are met, including customer satisfaction, productivity, and quality * Ensure that all contract obligations are met, and that the organization is compliant with regulatory requirements * Responsible for publishing group contracts and member benefit books * Develop and maintain relationships with internal stakeholders, including sales, marketing, customer service, clients and agents * Collaborate with external partners, including vendors and regulatory agencies * Develop and manage budgets, forecasts, and financial reports * Identify and implement process improvements to increase efficiency and effectiveness * Develop and implement training programs to ensure that staff have the necessary skills and knowledge to perform their jobs effectively * Ensure that all staff are aware of and comply with organizational policies and procedures The expected hiring range for The Manager, Group Member Services is $115k-$125k, depending on skills, experience, education, an To view the full job description,
