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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 Services is responsible for providing exceptional & dedicated support to the MES Team, while demonstrating & incorporating the Bright values into day to day operations.

ROLE RESPONSIBILITIES

The Supervisor, Member Services job description is intended to point out major responsibilities within the role, but it is not limited to these items:

  • Monitor calls and QA mentor, make decisions and deliver Performance Improvement Plan Action (or similar), approve/deny PTO, maintain 24 TAT for all tasks, train on systems, perform DLP maintenance, lead weekly team meetings and monthly 1:1s
  • Collaborates or assists with internal and external Bright Health Partners to resolve Enrollment, Eligibility, Billing, and Underwriting issues
  • Provides support to MES team in the areas of collecting outstanding premiums, working with State-based exchange or Federal Facilitated Marketplace (FFM) to resolve enrollment, grace-period, premium, billing, APTC/CSR disputes or discrepancies
  • Assist or support MES team to review all incoming enrollment quarantine items to determine whether the enrollment may be accepted, requires additional information or should be rejected
  • Participates as needed in the discovery and resolution of root cause for recurring issues
  • Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships
  • Communicate directly with members to discuss impact due to retroactive changes received from state-based exchange
  • Analyze and report daily/weekly/monthly metrics
  • Other duties and responsibilities as assigned

SUPERVISORY RESPONSIBILITIES

This position has supervisory responsibilities of member and enrollment specialist team members.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School diploma or GED required.
  • Three (3) years of IFP and/or FFM Health Insurance Industry required.
  • Three (3) to five (5) years of customer service experience required.
  • Claims or 834 EDI File experience preferred
  • Two (2)v years of leadership experience required.
  • Call monitoring and QA mentoring experience preferred
  • Experience with Performance Improvement Plans or similar required.
  • Experience with classroom and/or individual training sessions required.

PROFESSIONAL COMPETENCIES

  • Strong communication skills, both verbal and written
  • Organized and be able to prioritize work to meet deadlines
  • Works independently with little supervision
  • Able to thrive in an often-chaotic environment
  • Understands regulatory and compliance rules surrounding enrollment and eligibility
  • Results and detail oriented and understands the big picture
  • Able to work independently with little supervision
  • Able to thrive in an often-chaotic environment
  • Able to understand regulatory and compliance rules surrounding enrollment and eligibility
  • Results and detail oriented

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.

 

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.
 

 

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