Member Services Supervisor supervises a group of member services representatives that address health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Being a Member Services Supervisor assists with hiring, training, ongoing monitoring and QA, performance evaluations and any corrective actions of member services representatives. Requires a high school diploma or its equivalent. Additionally, Member Services Supervisor typically reports to a manager. The Member Services Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. Thorough knowledge of functional area under supervision. To be a Member Services Supervisor typically requires 3 years experience in the related area as an individual contributor. (Copyright 2024 Salary.com)
Smile, You’ve Found Us!
Are you passionate about caregiving? Would you like to work with the best team in the world? If so, Diversicare invites you to apply.
We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence, which we extend to all those we are privileged to serve.
If you wish to make a difference in the lives of our patients and residents, APPLY NOW!
Full Time Benefits include:
Diversicare provides post-acute care services to patients and residents at 61 skilled nursing and long-term care centers in eight states, primarily in the Southeast, Midwest and Southwest United States. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.
It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.”
We are guided to excellence by five Core Values: Integrity, Excellence, Compassion, Teamwork and Stewardship, as well as 12 Service Standards.
We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence. Our Service Standards are in place to offer support. They lead us to what matters most to our company: creating a warm, caring, safe and professional environment for our customers and each other.
Our culture of impassioned service delivery is the Diversicare Difference.
Assists in pre-admission and admission process with customers; aids clients in adjusting to nursing home placement.
Interviews residents and families to obtain relevant past and present adjustments, behavior and lifestyle.
Documents progress and updates plans of care at the interdisciplinary care conference.
Arranges transportation, makes appointments and acts as a liaison between all departments, residents’ families and outside agencies.
Assists in handling and accepting placement through one-on-one counseling and group work.
Ascertains potential and develops discharge plans when clients are admitted.
Arranges for post discharge services and follow-up care.
Assesses emotional, financial, spiritual, educational and social needs of residents; ensures those needs are Manager, Education & Training by the facility or through the use of outside agencies.
Acts as resident/family advocate and ensure the resident is knowledgeable in and exercises his/her rights.
Responsible for organizing and conduction of Family Counsel Meetings and maintaining minutes of the meeting.
Maintains effective communication with residents, families, healthcare professionals and facility staff.
License with State
One year of supervised social work experience in a health care setting, working directly with patients and families.
Experience in working in healthcare setting – preference in nursing home, hospice, home health, hospital.
Ability to work with a variety of people in situations varying from community and nursing home planning.
Able to make decisions concerning procedures based on evaluations and interpretations of case histories.
(EOE)
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0 Member Services Supervisor jobs found in Huntsville, AL area