Manager, Customer Care – Medicare Strategy

Job not on LinkedIn

🔥 55 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $83k - $132.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💝 Customer Support

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Provide leadership and direction to staff to ensure department goals and standards are achieved • Manage staff to ensure timely and accurate completion of tasks and issues • Oversee and monitor processes for regulatory requirements and accreditation standards • Oversee and ensure grievances and appeals are resolved and reported appropriately • Analyze grievances and appeals submissions and provide feedback to business areas • Develop, implement and execute grievances and appeals training • Analyze operations and identify process improvements • Identify irregular trends, determine root causes and support resolution steps • Monitor trends and regulatory changes for departmental impact • Report data to appropriate CareSource committees • Oversee, develop and execute grievances and appeals processes for new product lines • Review and interpret regulatory requirements and ensure policy and process compliance • Lead initiatives to track and trend grievances and appeals data to drive process improvements • Develop team accountability and flexibility aligned with the organizational mission and vision • Perform other duties as requested

🎯 Requirements

• Bachelor’s degree or equivalent years of relevant work experience is required • Prior experience in the healthcare industry is preferred • Minimum of three (3) years of management experience is preferred • Minimum of four (4) years of grievance and appeals experience is preferred • Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint • Basic experience with ACD systems • Basic experience with Call Management Systems • Excellent written and verbal communication skills • Strong interpersonal skills, high level of professionalism and a collaborative management style • Effective problem solving skills with attention to detail • Effective listening and critical thinking skills • Ability to work independently and within a team environment • Ability to develop, prioritize and accomplish goals • Strategic management skills • Familiarity of the healthcare field with knowledge of Medicaid and Medicare • Ability to work in a fast-paced and constantly changing environment • No licensure or certification required

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support