Hello, we’re Belong.

We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.

With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.

We believe that only by recognizing individuals can we make communities strong.

Belong Health. Kinder, more supportive care.

COMPANY OVERVIEW

Why do we exist?

Belong Health was created to bring a high-quality, seamless customer experience to vulnerable Americans with complex health needs. We believe that all Americans deserve an opportunity for optimal health, and we understand that health is related to many factors outside of traditional healthcare. We are dedicated to a vision of the future where holistic health incorporates data and technology into a humanistic and behaviorally sophisticated model of care.

What do we do?

Belong Health is a partner platform launch- built-for-purpose, technology-enabled healthcare organizations. They aggregate the leading talent in the market to solve specific problems in healthcare that improve the lives of patients and lead the industry towards a more rational, sustainable, and humane model of care. Belong Health partners with regional health plans to deliver best-in-class Medicare Advantage (MA) and Specials Needs Plan (SNP) products, creating new opportunities for organic growth that enable better service for their existing membership.

How do we do it?

Belong Health provides the services and funding to launch a new health plan: CC NewCo works with regional health plans to understand their relative market position & operational strengths, create specific strategies that deliver MA / SNP membership, and launch complementary but distinct new plans together.

 

POSITION OVERVIEW

Where do I fit in?

The Team Lead CSCC/CHW will work directly with CSCC/CHW team members to ensure that members have access to the range of supportive services needed to promote quality of life and the achievement of member identified desired outcomes. The  Team Lead CSCC/CHW will monitor and coach staff to address the needs and wishes of the member and his or her family and/or advocate and to support changes as they affect the member’s desired outcomes, quality of care and quality of life. 

 

The  Team Lead CSCC/CHW will be responsible to monitor staff on all aspects of customer service including monitoring phone queues, assigning incoming calls, and acting as a resource for issue escalations. The Team Lead CSCC/CHW will be responsible for assuring the team meets customer service and compliance key performance indicators such as  auditing phone calls and documentation for excellent and appropriate customer service.

 

The Team Lead CSCC/ CHW will educate and coach the staff regarding plan benefits, identification and arrangement of needed social and health support services, conduction of in-home visits, and required follow-up with the member and his/her designee on an ongoing basis. 

The Team Lead CCSC/CHW will work under the supervision of the Director of Care Management

SCOPE OF RESPONSIBILITIES

  • Orient new members to the Belong Health DSNP program.
  • Provide on-going support to staff related to the coordination of and access to services, grievances, and appeals, claims inquiry, social services etc.
  • Ensure and monitor the that the team meets key performance indicators such member linkages to community resources and completing assigned surveys through auditing documentation, reports and phone calls
  • Ensure and monitor the team’s customer service actions to include empathetic listening, motivational interviewing, superb customer service and appropriate follow up actions, as well as assuring the team meets customer service and compliance key performance indicators
  • May facilitate meetings with physician representatives to identify member health needs as necessary.
  • Work with internal Belong Health DSNP staff to assist staff in resolving member issues around billing, service denials, payment, authorization, interaction, appeals, grievances, and other member issues.
  • Ensure complete communication feedback to/from members regarding problem resolution, product design, and member eligibility, other post-enrollment activities, etc.
  • Ensure compliance with clinical quality language measures and standards.
  • Coach staff to familiarize member with appropriate member communication materials, including evidence of coverage, network directories and other materials as necessary.
  • Review, facilitate and monitor the implementation of the member care plan in accordance with recommendations by the Interdisciplinary Care Team and ensuring accurate and timely authorization.
  • This position has a broad range of on-phone and off-phone responsibilities. On-phone responsibilities include responding to customer inquiries in areas of enrollment, billing, claims, benefit interpretation, and referrals/authorizations for medical care. Other on-phone duties include Help Desk support and the handling of escalated issues (calls). Off-phone work may include service issue research and resolution, reporting, special projects, assist with training, facilitating, and attending meetings, walk-in coordinator duties on a back-up basis as needed, etc.
  • Promote a culture of accountability and performance to both meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues

 

COMPETENCIES

Role-based

Follow-through on commitments. Lives up to verbal and written agreements, regardless of personal cost.
Attention to detail.​ Does not let important details slip through the cracks or derail a project.

Persistence. ​Demonstrates tenacity and willingness to go the distance to get something done.

Proactivity.​ Acts without being told what to do. Brings new ideas to the team. Creativity/innovation​. Generates new and innovative solutions to problems.

Enthusiasm​ - Exhibits passion and excitement over work. Has a can-do attitude.
Listening skills​ - Lets others speak and seeks to understand their viewpoints.

Communication​ - Speaks and writes clearly and articulately without being overly verbose or talkative. Maintains this standard in all forms of written communication, including e-mail. Teamwork.​ Reaches out to peers and cooperates with supervisors to establish and overall collaborative working relationship.

Culture

ON-TIME ​- Someone who respects other people’s time, efficient with time, completes tasks on time, speaks up if the time expectations are not realistic.
ACCOUNTABLE​ - Someone who consistently does what they say they are going to do when they say they are going to do it.

ACTIVE PARTNER​ - Someone who is a proactive team member, willing to jump in and lend a hand without being specifically asked to do so.

CANDIDATE QUALIFICATIONS

  •  Valid New York State driver’s license

 

Education/Degree:    

  • Preferred Associates or Bachelor’s degree in social / health sciences, business or health related field.

 

Knowledge:

  • Working knowledge of Medicare and Medicaid programs and experience with regulatory requirements and reporting.
  • Knowledge of managed care and / or member services.
  • Knowledge of community services and resources for elders and disabled.
  • Familiarity with coordinated care models is an advantage.

 

Experience:    

  • 2+ years’ experience in a customer service, health care organization, Community Based Organization, or social services environment.
  • Demonstrated experience in a managed care or HMO setting is strongly preferred
  • Three (3) to Five (5) years of progressively responsible work in a high-volume health care related call center or social-service related setting.

 

Required Skills:   

  • Understanding of the needs and dynamics of elder care services, disadvantaged, and disengaged populations.
  • Experience in participating in cross departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments.
  • Demonstrated ability to work in a fast-paced, high volume call-center environment.
  • Passionate about customer service with a continuous improvement mindset.
  • Excellent problem solving, trend identification, and analytical skills, with a demonstrated ability to problem solve effectively and efficiently.
  • Commitment to high ethical standards in all work; protects the privacy of member and Belong data and exercises discretion in handling confidential member information.
  • Excellent oral and written communication skills, including presentation skills.
  • Demonstrated PC skills using Microsoft applications.
  • Must be able to travel to other office locations, as necessary.
  • Must be able to work flexible schedule.
  • In depth knowledge of managed care product portfolio, benefits, policies and procedures.
  • Strong active listening, issue assessment and problem-solving skills.
  • Strong organizational and follow through skills.
  • Ability to exercise discretion in handling confidential member information.
  • Passion for customer service and process improvement.
  • Self-directed individual.

Working Conditions:

  • Office work; may be sitting for long periods of time.
  • Some travel may be required.
  • Ability to work independently and maintain flexibly in fast paced start up environment.
  • Must have access to reliable daily transportation.

PREFERRED EXPERIENCE

  • Superior knowledge of healthcare products and services.
  • Bilingual (Spanish) a plus.

 

 

 

 

 

 

Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.

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