Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
Reports to the Director level and is responsible for all department activities. Develops and implements policies and procedures as necessary to ensure timeliness and accuracy. May involve creating reports and delivering to leadership as necessary. Collaborates with select departments to update and maintain documentation of all manuals, guidelines, policies and workflows which govern the daily workflow. Various related management of support staff to effectively coordinate all of these functions.
Responsible for planning, managing, and organizing the functions of the Member Experience team. Establishes policies and procedures to intake, research, and respond to member complaints, grievances, and a variety of escalated issues. Coordinates and oversees the work of the Member Experience team, to include tracking volume, outcomes, timeliness, and actionable trends. Plans and organizes interventions and programs to drive member experience and retention across the organization, and closely monitors the outsourced functions of the plan that impact the member and recommends corrective action if needed. Regularly collaborates with other areas of the organization to review and improve member perception of the plan. Will communicate verbally and in writing directly to members as needed to respond to complaints and escalations. Plans and leads member experience and retention efforts, monitors and reports on call center performance, represent the team in leadership meetings and audits, and lead the Member Experience Workgroup.
Requires a Bachelor’s Degree in Business or closely related field. Associate's Degree and equivalent work experience may substitute for some education requirements.
Work requires knowledge of CMS requirements and Medicare plans. Must have knowledge of managed care products, operations, process improvement, and assessing customer expectations. Knowledge of call center operations and customer service quality is required. Familiarity with Medicare claims, enrollment, and appeals is required.
Work requires excellent communication, writing and interpersonal skills to effectively interface with all levels of staff and members. Work requires the ability to handle sensitive and confidential information, communicate and exchange information with all levels of staff and external business-related agencies and members. Requires excellent leadership and teamwork skills to build and maintain relationships across the organization. Work requires excellent organization skills and the ability to think creatively to handle day-to-day situations.
D. Required Licensure, Certification, Etc.:
E. Work Experience:
Work requires a minimum of five (5) years’ experience in the healthcare industry, and a minimum of 2 years leading/managing staff. Medicare experience is required. Must have experience in a customer-focused environment with an emphasis on quality.
F. Machines, Tools, Equipment:
Must be able to operate general office and communications equipment.
Requisition #: 168288