Concierge

SHPCA SCAN Health Plan•Long Beach, CA

3d•$24 - $42•Remote

About The Position

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org , www.scanhealthplan.com , or follow us on LinkedIn, Facebook, and Twitter. The job Through alignment of values and SCAN’s member-centric customer service philosophy, this position is responsible for proactive resolution of member issues in pursuit of Member satisfaction. This role will deliver highly effective and efficient customer solutions to SCAN members using one call resolution methodology leveraging internal departments, external PMG contacts, and product knowledge. You will Own and manage primary book of membership business for the assigned Primary Medical Groups (PMGs). Act as the benefit Subject Matter Expert for the assigned PMGs, by possessing deep knowledge and specialized skill set pertaining to Member benefits and PMG's policies and procedures. Increase member satisfaction by following up and resolving member issues, concerns, and questions in an efficient, timely and accurate manner; coordinate resolution with PMG and SCAN internal departments, as needed. Log and trend common member and PMG issues in order to identify communication and workflow gaps between members and PMGs. Responsible for prioritization of the team's daily assignments, including but not limited to review of pending member issues, pending research, and coordination of workload to supporting team members. Empowered to coach and guide supporting team on escalated member issues in support of high member satisfaction. Consistently meet and/or exceed the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance. Responsible for fostering a positive relationship with PMGs and identifying a point of contact for escalated member matters. Continuously building and maintaining a strong rapport in order to meet and/or exceed members' needs. Responsible for fostering positive relationships with internal constituents and departments, by working cross-functionally and collaboratively to resolve member and PMG issues. Participate in member calling projects as assigned by management to support the overall SCAN goal of membership retention. Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations, as documented in company policies and procedures. Follow all HIPAA requirements. Document transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.

Requirements

Customer service experience required.
Demonstrated time management and priority setting skills; ability to multi-task and manage the changing needs of the members.
Ability to deal with ambiguity, while working cross-functionally and collaboratively across the organization.
Ability to research, analyze and resolve member issues independently, while demonstrating compassion and responsiveness.
Ability to effectively present information and respond to questions from members, PMGs, peers and management.
Ability to speak using clear and professional language and answer telephone using appropriate etiquette.
Ability to work in a fast paced environment with changing priorities, while maintaining a calm demeanor.
Technologically savvy and able to utilize information systems effectively.
Strong interpersonal skills, including excellent written and verbal communication skills.
Strong organizational skills; Ability to multitask.
Ability to appropriately maintain confidentiality.
Strong analytical and critical thinking skills, required.

Nice To Haves

Call Center or provider office experience a plus.
Bilingual Preferred.

Responsibilities

Own and manage primary book of membership business for the assigned Primary Medical Groups (PMGs).
Act as the benefit Subject Matter Expert for the assigned PMGs, by possessing deep knowledge and specialized skill set pertaining to Member benefits and PMG's policies and procedures.
Increase member satisfaction by following up and resolving member issues, concerns, and questions in an efficient, timely and accurate manner; coordinate resolution with PMG and SCAN internal departments, as needed.
Log and trend common member and PMG issues in order to identify communication and workflow gaps between members and PMGs.
Responsible for prioritization of the team's daily assignments, including but not limited to review of pending member issues, pending research, and coordination of workload to supporting team members.
Empowered to coach and guide supporting team on escalated member issues in support of high member satisfaction.
Consistently meet and/or exceed the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance.
Responsible for fostering a positive relationship with PMGs and identifying a point of contact for escalated member matters.
Continuously building and maintaining a strong rapport in order to meet and/or exceed members' needs.
Responsible for fostering positive relationships with internal constituents and departments, by working cross-functionally and collaboratively to resolve member and PMG issues.
Participate in member calling projects as assigned by management to support the overall SCAN goal of membership retention.
Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations, as documented in company policies and procedures.
Follow all HIPAA requirements.
Document transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.

Benefits

A competitive compensation and benefits program
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 additional floating holiday
Excellent 401(k) Retirement Saving Plan with employer match
Robust employee recognition program
Tuition reimbursement
A work-life balance
An opportunity to become part of a team that makes a difference to our members and our community every day!