Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Supervisor, Member & Provider Services is responsible for providing exceptional & dedicated support to the contact center team, while demonstrating & incorporating the Bright values into day to day operations.
The Supervisor, Member & Provider Services job description is intended to point out major responsibilities within the role, but it is not limited to these items.
Collaborate across the organization to resolve complicated issues related to claims which could include Enrollment, Billing, Provider Relations, Utilization Management, Sales, Broker Services, and all vendors. Properly recognize and triage complaints, grievances and appeals in a timely manner
Participates as needed in the discovery and resolution of root cause for recurring issues.
Monitor and QA calls, make decisions and deliver Performance Improvement Plan Action (or similar) as needed, Coaching and developing team to drive performance and overall quality
Approve/deny PTO, maintain 24 TAT for all tasks, train on systems, perform DLP maintenance, lead weekly team meetings and monthly 1:1s.
Analyze and report daily/weekly/monthly metrics.
Other duties and responsibilities as assigned.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
High School diploma or GED required.
Three (3) years of healthcare claims experience
Three (3) to five (5) years of customer service experience required.
Two (2)+ years of leadership experience required.
Call monitoring and QA mentoring experience preferred but not required.
Experience with Performance Improvement Plans or similar required.
Experience with classroom and/or individual training sessions required.
Familiarity with in-depth research of claims involving fee schedules, benefit interpretation, payment processing, and provider data
Ability to deescalate emotionally charged conversations and provide timely resolution
Must have strong communication skills (verbal and written) over multiple communication channels.
Must be highly organized and be able to prioritize work to meet deadlines
Must be successful working in an environment of ambiguity and change
Display strong strategic behaviors such as initiative, problem solving, critical thinking, judgment, innovation and independence
Works independently with little supervision
Results and detail oriented
Ability to form and lead a unified team
Ability to influence and collaborate with business partners throughout the organization.
Bi-lingual (Spanish) is a plus
LICENSURES AND CERTIFICATIONS
Producer licensing for Health & Accident in the state in which an individual resides is preferred.
This position is located in Tempe, AZ
Most work responsibilities are performed in an open office setting, carrying out detailed work sitting or standing at a desk/table and working on the computer. Some travel may be required.
Live by the Bright values to maintain a strong, collaborative culture
Be a role model for the team as to why Bright Health is truly a “Great Place To Work”
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.