Manager Member & Provider Operations - Hybrid

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier community. Martins Point employees enjoy an organizational culture of trust and respect where our values - taking care of ourselves and others continuous learning helping each other and having fun - are brought to life every day. Join us and find out for yourself why Martins Point has been certified as a Great Place to Work since 2015.

Key Outcomes:

• Develops and manages the customer service and experience continuum (from post-sale through long-term service) to deliver the highest satisfaction and enduring relationships with our Health Plan members.
• Works across the health plan to drive service improvements based on member feedback.
• Develops and maintains a team approach in the management of employees.
• Guides the development of reports to identify trends increase functionality and evaluate employee performance. Drives improvements based on data.

• Collects and analyzes member and market information to aid in the development of initiatives and activities for engaging members and inform product development.
• Analyzes and trends phone queues to guide workforce planning and maximize use of telephone system.
• Analyzes and trends in member service data which results in the identification of process improvement activities improving member and employee experience and satisfaction (e.g. call tracking reports telephone reports satisfaction surveys etc.).
• Designs and implements operational processes and systems that increase customer service levels.

• Acts as advisor to Health Plan leadership regarding member inquiry trends.
• Works collaboratively with other departments and with organizational functions to maximize operational efficiency quality and effectiveness of service.
• Manages and coaches member services staff to perform effectively as a team to support MP strategies with an intense focus on customer service/support and proactive problem solving.
• Manages operational auditing activities set forth by CMS and DOD for the functions denoted above.

Education/Experience:

• Bachelor degree or equivalent combination of relevant education and experience required
• 5 years related experience in business insurance health care and/or customer service required
• Experience in a Managed Care customer service environment preferred
• Leadership experience (staff and/or projects) required. Prior experience in service supervision of staff training operations preferred

Skills/Knowledge/Competencies (Behaviors):

• Ability to build and manage strong internal and external relationships
• Proficient in using data analysis software
• Strong customer service orientation
• Excellent organizational skills

• Exceptional public speaking skills
• Ability to multitask
• Detail oriented with continuous attention to compliance/contractual requirements

There are additional competencies linked to individual contributor provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer.

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