Health Plan Member Services Coordinator
About The Position
Contra Costa Health is the largest county department in Contra Costa County with over 4,700 employees. Our mission is to care for and improve the health of all people in Contra Costa with special attention to those who are most vulnerable to health problems. We provide services through nine operational areas: Behavioral Health, Contra Costa Health Plan, Emergency Medical Services, Environmental Health, Hazardous Materials, Health, Housing & Homeless Services, Public Health, Contra Costa Regional Medical Center & Health Centers and Detention Health. The Contra Costa Health Services Department is recruiting for two (2) qualified candidates for the Health Plan Member Services Coordinator positions assigned to the Contra Costa Health Plan (CCHP) Division located in Martinez, CA. The Health Plan Member Services Coordinator is responsible for providing advanced technical expertise, facilitating the resolution of member inquiries, complaints, grievances and appeals, including formal investigations, assisting with the unit operations, and providing direction and assistance to the Health Plan Member Services Counselors. Contra Costa Health Plan (CCHP) has been serving county residents with their health needs for over 40 years and was the first Federally qualified, State licensed, County sponsored Health Maintenance Organization (HMO) in the United States. Also, Contra Costa Health Plan (CCHP) became the first County sponsored health plan in California to offer MediCal Managed Care coverage. We are looking for someone who: Is a skilled mediator when handling complex situations in a union environment Has experience in staff activity planning and coordination of work schedules Is proficient with computer office productivity tools and customer relationship management systems Is efficient in interpreting rules, regulations, and guidelines applicable to enrollment, disenrollment, and eligibility for health plans
Requirements
- Possession of a valid California Motor Vehicle Operator's License. Out of state valid motor vehicle operator's license will be accepted during the application process.
- Possession of a high school diploma, G.E.D. equivalency or a high school proficiency certificate.
- Either three (3) years of full-time experience, or its equivalent, in a health plan setting performing customer service, member education, financial counseling or processing medical records which required direct patient contact, one year of which must have been in a lead capacity; OR two (2) years of full-time experience, or its equivalent, in a job classification equivalent to Contra Costa County Health Plan Member Services Counselor.
Nice To Haves
- Experience and recent knowledge of Federal and State health care programs (ex: Medi-Cal)
- Ability to type 45 words per minute
Responsibilities
- Facilitating the resolution of challenging member inquiries, grievances, and appeals
- Providing daily lead direction to the Health Plan Member Services Counselors
- Interacting with the Member Services unit to resolve member issues affecting multiple units
- Assisting in internal audit preparation and activity
Benefits
- You will have career stability and opportunity for growth
- You will work with a supportive team with shared goals that are aligned with the organization's commitment to serve the community
- You will gain professional experience in a broad range of health care issues
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Administration of Economic Programs
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
