Search Salaries
Smarter prices start with HR-reported pay data
Employees: Get a Salary Increase
Salaries
View salary and benefits informationDirects and coordinates all aspects of the health maintenance organization (HMO) member services department. Plans and directs policies and objectives for addressing member inquiries. Establishes service quality goals for the department and implements strategies to meet these goals. Typically requires a bachelor's degree. Typically reports to top management. Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep more...
The Health Plan Member Services Director plans and directs policies and objectives for addressing member inquiries. Directs and coordinates all aspects of the health maintenance organization (HMO) member services department. Being a Health Plan Member Services Director typically requires a bachelor's degree. Establishes service quality goals for the department and implements strategies to meet these goals. In addition, Health Plan Member Services Director typically reports to top management. The Health Plan Member Services Director manages a departmental sub-function within a broader departmen more...
Responsible for daily activities in the member services function for a health plan or health maintenance organization (HMO). Collects data on member inquiries and service requests and conducts analysis to identify trends and recommend solutions. Ensures service representatives follow established policies for addressing member inquiries and meet service quality goals. Manages the recruitment, hiring, training, scheduling, and performance management of staff. Requires a bachelor's degree. Typically reports to a head of unit/department. Manages subordinate staff in the day-to-day performance of t more...
Supervises a group of member services representatives that address health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for researching more complex questions, investigating the cause of the issue, and responding to members on escalated issues. Assists with hiring, training, ongoing monitoring and QA, performance evaluations and any corrective actions of member services representatives. Requires a high school diploma or its equivalent. Typically reports to a mana more...
Addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls, or written questions. Provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor or manager. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of disci more...
Directs the strategy, design, and operations of education programs to reflect the mission and focus of the organization and the needs of its members and public community. Leads curriculum and content development for classes, workshops, lectures, conferences, and certification programs and testing. Conducts research to define learning and skill development objectives and provide members with meaningful and up-to-date educational offerings. Develops relationships and alliances with industry leaders and subject matter experts to keep abreast with technological changes and trends. Ensures educatio more...
Addresses more complex health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls and written requests. Provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Requires a high school diploma or equivalent. Typically reports to a supervisor or manager. Works independently within established procedures associated with the s more...
Plans and directs all aspects of an organization's oncology services policies, standards, and programs. Responsible for strategic clinical relationships with physicians and interns. Ensures oncology clinical programs are in compliance with all applicable regulations. Researches and studies current medical publications and data on new treatments and practices to ensure high quality clinical service offerings. Advises non-medical management on clinical and patient related matters and policies. Requires a MD. Typically reports to top management. Manages a departmental sub-function within a broade more...
The Health Plan Member Services Representative is responsible for receiving, responding to, and directing member phone calls, or written questions. Addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Being a Health Plan Member Services Representative maintains confidentiality per HIPAA guidelines. Provides available information upon request and researches or escalates issues as appropriate. In addition, Health Plan Member Services Representative requires a high school diploma or its more...
The Health Plan Member Services Manager collects data on member inquiries and service requests and conducts analysis to identify trends and recommend solutions. Responsible for daily activities in the member services function for a health plan or health maintenance organization (HMO). Being a Health Plan Member Services Manager manages the recruitment, hiring, training, scheduling, and performance management of staff. Ensures service representatives follow established policies for addressing member inquiries and meet service quality goals. In addition, Health Plan Member Services Manager requi more...
Hot Topics for HR Professionals
Fill the Gaps
With CompAnalyst Market Data you have access to the largest and most reliable HR-reported compensation data set. Market price hot jobs, industry-specific positions, and even combine jobs to map to your specific needs, drastically reducing your data gaps.
Bring Order to Chaos
Without a well-defined process it is nearly impossible to manage job descriptions effectively.
JobArchitect gives you the flexibility to design a workflow for your organization or upload an existing one. With our centralized command center, you can track progress and job description status with ease. And your revision history is automatically documented, giving you insight into how a position has evolved over time and a paper trail to support audits.
Compdata Surveys
Get comprehensive data and unparalleled insights into total rewards practices across the US for the industries and pay markets you care about most.
Hot Topics for Job Salary Data
Adjust Employee SalaryIndividualize employee pay based on unique job requirements and personal qualifications. |
|
Price My Industry JobsGet the latest market pricing for benchmark jobs and jobs in your industry. |
|
Individualize employee pay based on unique job requirements and personal qualifications.
Get the latest market pricing for benchmark jobs and jobs in your industry.
Analyze the market and your qualifications to negotiate your salary with confidence.
Search thousands of open positions to find your next opportunity.