SCOPE OF ROLE

The Supervisor, Member Services is responsible for providing exceptional & dedicated support to the MES Team, while demonstrating & incorporating the Bright values into day to day operations.

ROLE RESPONSIBILITIES

The Supervisor, Member Services job description is intended to point out major responsibilities within the role, but it is not limited to these items:

• Monitor calls and QA mentor, make decisions and deliver Performance Improvement Plan Action (or similar), approve/deny PTO, maintain 24 TAT for all tasks, train on systems, perform DLP maintenance, lead weekly team meetings and monthly 1:1s
• Collaborates or assists with internal and external Bright Health Partners to resolve Enrollment, Eligibility, Billing, and Underwriting issues
• Provides support to MES team in the areas of collecting outstanding premiums, working with State-based exchange or Federal Facilitated Marketplace (FFM) to resolve enrollment, grace-period, premium, billing, APTC/CSR disputes or discrepancies
• Assist or support MES team to review all incoming enrollment quarantine items to determine whether the enrollment may be accepted, requires additional information or should be rejected
• Participates as needed in the discovery and resolution of root cause for recurring issues
• Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships
• Communicate directly with members to discuss impact due to retroactive changes received from state-based exchange
• Analyze and report daily/weekly/monthly metrics
• Other duties and responsibilities as assigned

SUPERVISORY RESPONSIBILITIES

This position has supervisory responsibilities of member and enrollment specialist team members.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• High School diploma or GED required.
• Three (3) years of IFP and/or FFM Health Insurance Industry required.
• Three (3) to five (5) years of customer service experience required.
• Claims or 834 EDI File experience preferred
• Two (2)v years of leadership experience required.
• Call monitoring and QA mentoring experience preferred
• Experience with Performance Improvement Plans or similar required.
• Experience with classroom and/or individual training sessions required.

PROFESSIONAL COMPETENCIES

• Strong communication skills, both verbal and written
• Organized and be able to prioritize work to meet deadlines
• Works independently with little supervision
• Able to thrive in an often-chaotic environment
• Understands regulatory and compliance rules surrounding enrollment and eligibility
• Results and detail oriented and understands the big picture
• Able to work independently with little supervision
• Able to thrive in an often-chaotic environment
• Able to understand regulatory and compliance rules surrounding enrollment and eligibility
• Results and detail oriented

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.