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Member Relations Coordinator in Orange at Prospect Medical Systems

Date Posted: 10/8/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    10/8/2018
  • Job ID:
    10809

Job Description



Member Relations Coordinator

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Member Relations Coordinator is responsible for acting as a liaison between members, health plans, and physicians. Individual will perform outbound telephone calls to Medi-Medi, Medicare, Commercial, POS, Healthy Families, and Medi-Cal members who are existing members with enrollment errors or are identified as potential terminations or terminated. Individual will perform outbound telephone calls to Medi-Medi, Medicare, Commercial, POS, Healthy Families, and Medi-Cal members who are who are new members requiring company overview. Individual will also accept inbound telephone calls from members returning telephone calls. Individual will assist members via telephone with services necessary to ensure member healthcare satisfaction, wellness, and retention is accomplished.



Job Responsibilities/Duties

  • Outbound Telephone Calls for Welcome Calls with completion of 100% outreach of calls within defined timeframe.
  • Outbound Telephone Calls for Member Terminations with completion of 100% outreach of calls within defined timeframe. 50% goal for member voluntarily retention (ProMed Health Care included).
  • Thorough documentation of telephone call conversation to include details and action taken. Every new call must generate a new documentation record in our company system. Every follow-up call must be documented in existing documentation record. The monthly expectation is to produce a quality level of 95%. The call documentation record ratio should be at 100%. All open/on-hold documentation records must be resolved and closed within 30 calendar days.
  • Outbound Telephone Calls for Primary Care Physician Terminations. Completion of 100% outreach of calls within defined timeframe. 50% retention goal for member voluntary terminations (ProMed Health Care included).
  • Outbound Telephone Calls for Unassigned Primary Care Physicians.
  • Providing monthly reports or when asked upon from assigned outreach projects.


Qualifications

Minimum Education: Bachelor’s Degree preferred. High School Diploma or equivalent required.

Minimum Experience: A minimum of two (2) to three (3) years of IPA/HMO experience. Ability to project excellent customer service, negotiation, and conflict resolution skills via telephone in a fast-pace environment while maintaining a professional demeanor. Bi-lingual preferred. Must be able to speak, read, and write English proficiently.

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit   http://pmh.com/careers/  and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm

Keywords: Membership relations, Members, Medi-Cal, Medicaid, Medical Insurance.



10809

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