Member Advocate Supervisor in San Antonio, Texas at University Health System- San Antonio

POSITION SUMMARY/RESPONSIBILITIES

Supervise, assist, and direct the activities of the team leader, senior member service representatives, and member service representatives within the Member Services’ TPA which includes STAR and CHIP call center. Serve as a Supervisor and advocate to assist and/or represent TPA members on their behalf, in navigating the complaint and appeals process and providing education and support to access necessary services. To include communication via correspondence as needed. This individual may work closely with the Member team and may facilitate mediation in cases of reported complaints regarding service coordination. They may also assist the member in accessing non-covered services, such as those provided in other social service or community programs. Supports perform annual performance reviews of assigned staff in conjunction with Sr. Manager. Responds to issues escalated from staff regarding information, education, issues, or complaints providing solutions to problems in accordance with health plan’s policies and procedures. Develop and implement methods to improve customer service within the call center. Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) related policies in regard to all aspects of operations within the Member Services SHCN call center

EDUCATION/EXPERIENCE

Bachelor’s degree in business, health care or related field or equivalent experience is required. Customer service and experience with special healthcare members is preferred, health care resolving experience helpful but not required. Minimum of three years’ supervisory experience in a health maintenance setting required