Skills & Competencies for Member Services Manager

Member Services Manager job profile

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JOB SUMMARY for Member Services Manager

Responsible for daily activities in the member services function for a health plan or health maintenance organization (HMO).

JOB RESPONSIBILITIES for Member Services Manager

Collects data on member inquiries and service requests and conducts analysis to identify trends and recommend solutions. Ensures service representatives follow established policies for addressing member inquiries and meet service quality goals. Manages the recruitment, hiring, training, scheduling, and performance management of staff.

Member Services Manager SALARY RANGE

BASE 50%
$93,373
TOTAL 50%
$98,905
Job Level
M02
Job Code
HC07000380
Education/Degree
Bachelor's Degree
Reports To
Head of a Unit/Department

Member Services Manager Skills and Competencies List

Proficiency Levels and Behavioural Indicators
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Member Services Manager skill and competencie below to view definitions.
JOB FAMILY COMPETENCIES CORE COMPETENCIES
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6 general skills or competencies (Job family competencies) for Member Services Manager

1 Job Family Competencies – HIPAA Compliance
Proficiency Level -2
Skill definition-Abiding in the act protects sensitive patient health information from being disclosed without the patient's consent and knowledge.
Level 1 Behaviors
(General Familiarity)
Lists needed requirements for abiding HIPAA compliance in our organization.
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Level 2 Behaviors
(Light Experience)
Records and reports potential security and compliance risks regarding HIPAA Privacy rules.
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Level 3 Behaviors
(Moderate Experience)
Performs investigation of HIPAA incidents to meet government and industry compliance standards.
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Level 4 Behaviors
(Extensive Experience)
Oversees all phases of HIPPA compliance analysis to optimize the organization's enforcement of privacy policies.
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Level 5 Behaviors
(Mastery)
Stays current of new technologies and processes impacting our organization’s HIPPA compliance program.
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2 Job Family Competencies – Healthcare Industry
Proficiency Level -3
Skill definition-Applying healthcare industry knowledge to manufacture drugs and equipment and offer clinical and other healthcare-related support services.
Level 1 Behaviors
(General Familiarity)
Describes current systems and scope of services provided by healthcare organizations.
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Level 2 Behaviors
(Light Experience)
Conducts research on existing issues within the healthcare industry and possible solutions.
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Level 3 Behaviors
(Moderate Experience)
Identifies cost-effective solutions to address regulatory compliance challenges in healthcare services.
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Level 4 Behaviors
(Extensive Experience)
Develops a framework that promotes cross-functional cooperation and communication to optimize healthcare service.
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Level 5 Behaviors
(Mastery)
Develops and establishes risk reduction best practices to mitigate security breaches in our healthcare organization.
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3 Member Services Manager - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Member Services Manager
Proficiency Level - 4
5 Competency for - Member Services Manager
Proficiency Level - 5

12 soft skills or competencies (core competencies) for Member Services Manager

1 Core Competencies – Budgeting
Proficiency Level -2
Skill definition-Applying specific policies, tools and practices to plan and prepare projected revenues, expenses, cash flows, and capital expenditures.
Level 1 Behaviors
(General Familiarity)
Describes the concepts and principles of budgeting operations.
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Level 2 Behaviors
(Light Experience)
Gathers data from financial statements to help create budget plans and improve budgeting strategies.
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Level 3 Behaviors
(Moderate Experience)
Implements strategic operational efficiencies and techniques for conducting successful budgeting.
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Level 4 Behaviors
(Extensive Experience)
Determines system capabilities and needs to improve the process for financial budgeting.
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Level 5 Behaviors
(Mastery)
Develops financial models to support the strategic improvement of our budgeting processes.
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2 Core Competencies – Service Excellence
Proficiency Level -3
Skill definition-The capability of consistently delivering outstanding customer experiences to meet and even exceed customers' expectations.
Level 1 Behaviors
(General Familiarity)
Emphasizes the importance and value of providing excellent service.
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Level 2 Behaviors
(Light Experience)
Directs customers to the appropriate team or department if predicament cannot be immediately resolved.
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Level 3 Behaviors
(Moderate Experience)
Contributes to a service recovery program to rectify the situation and regain the client's trust.
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Level 4 Behaviors
(Extensive Experience)
Coaches others on superior customer service strategies in diverse situations.
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Level 5 Behaviors
(Mastery)
Defines organizational service excellence vision, mission, and strategy.
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3 Member Services Manager - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Member Services Manager
Proficiency Level - 4
5 Competency for - Member Services Manager
Proficiency Level - 5

Summary of Member Services Manager skills and competencies

There are 0 hard skills for Member Services Manager.
6 general skills for Member Services Manager, HIPAA Compliance, Healthcare Industry, Healthcare Knowledge, etc.
12 soft skills for Member Services Manager, Budgeting, Service Excellence, Planning and Organizing, etc.
While the list totals 18 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Member Services Manager, he or she needs to be proficient in Budgeting, be skilled in Service Excellence, and be skilled in Planning and Organizing.

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