Manager, Member Services - The Health Plan

 
Position: Manager, Member Services - The Health Plan

Job ID: 156738

Location: US-TX-Bellaire

Department: Member Services Admin

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 7a - 7p Monday - Friday; 7a -12p Saturday

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Manager of Member Services -- someone who works well in a fast-paced setting. In this position, you will manage a high performance, culturally sensitive and competent customer service Call Center that supports a rapidly growing, diverse membership and provider community and an expanding portfolio of health plan options. You will evaluate staff development, customer service results, and operational processes to ensure excellence in service, customer satisfaction, and compliance with accrediting and regulatory agencies.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities

  • Acts as an internal advocate for external customers, collaborating with other department managers to meet customers’ needs
  • Develops and implements training strategies that support the quality objectives and creates a continuous learning environment for professional growth
  • Ensures compliance with all regulatory (TDI, HIPAA, CMS, etc.) and accrediting (JCAHO, NCQA, etc.) requirements
  • Interviews, assesses, and selects candidates for hire
  • Participates in outreach activities designed to educate the community about available pediatric health plan options
  • Ensures that JCAHO and CAP requirements specific to your department are fulfilled but also understand the linkage between your department’s requirements and those of the integrated delivery system


Qualifications:

Skills & Requirements

  • High school diploma or GED required
  • Bachelor’s degree in business administration, health administration, and marketing or related field preferred
  • 6 years’ experience as a team leader or supervisor in Member Services, Claims Administration, or Provider Relations required
  • A Bachelor's degree in Business Administration, Health Administration, Marketing, or a related field may be substituted for four years of required experience


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