Underwriting Team Lead
Boston, MA jobs
In this position, the Team Lead will be responsible for interpreting insured and agency analytics, work collaboratively across the organization, execute processes to identify and address Rate Evasion, identify potential areas of risk and work internally with Claims, Sales, Product and Customer Care and directly with insured and agencies to resolve findings. At all times represent the brand, deliver Six Sigma results while maintaining the highest level of customer experience. This role will be focused on Massachusetts state results and responsibilities that extend across New England and New York.
To meet the needs of our organizations and the clients we services your role may be asked to support Customer Care inquiries, Endorsement processing, quoting and any other activities that will support the organizations success. Further, the Team Lead will have responsibility in overseeing Customer Care general support, including but not limited to supporting endorsements as well as monitoring service level.
Responsibilities
Become a knowledge resource for state regulator requirements, the firm's products and underwriting guidelines and philosophy.
Maintain documentation of department procedures.
Provide feedback and input into potential process improvements.
Deliver timely and accurate progress reports and monthly business results as required.
Execute and maintain a repeatable Rate Pursuit analytical process that evaluates insured's and our agency force.
Constantly and consistently evaluate methods that will enable the firm to maximize premium collection.
Be available and approachable and thoughtfully address escalated issues, complaints, questions and inquiries.
Execute multiple Rate Pursuit, New Business and Renewal projects. This may include home inspections, new business policies, umbrella renewal questionnaires, driver discovery, questionable risk referrals and garaging analysis.
Work closely with the Claims department to evaluate trends and take appropriate Underwriting action.
Be the lead trainer for new underwriting associates and maintain all training procedures
Be responsible for quality assurance checks of the teams tasks and report to supervisor
Function in leadership capacity when management is unavailable
Capable of working independently with minimal supervision
Serve as point of contact for Marketing and collaborate on positioning agencies
Assess team for training opportunities and development needs to ensure opportunity of growth
Set a professional example in both approach and work ethic
Special projects as assigned
Some travel will be required
Knowledge, Skills, and Abilities Required:
Experience in analyzing and interpreting qualitative and quantitative data/results.
Excellent organizational and communication skills.
Exceptional analytical, critical thinking and problem solving skills.
Strong knowledge of customer care techniques and processes.
Excellent written and oral communication skills.
Ability to multitask.
Sound knowledge of Microsoft Office with good - excellent EXCEL skills
Education & Experience:
The ideal candidate will possess 4-6 years of relevant underwriting experience.
Personal Lines Auto and Home experience preferred.
P&C Licensed
Salary Range:
The pay range for this position is $68,500 to $109,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
Benefits & Perks:
Paid time off
Free onsite gym at our Boston location
Tuition reimbursement
Low cost and excellent health insurance coverage options that start on Day 1 (medical, dental, vision)
Robust health and wellness programs
Auto and home insurance discounts
Matching donation opportunities
Annual 401(k) employer contribution
Various Paid Family leave options including Paid Parental Leave
Resources to promote professional development
Convenient locations and pre-tax commuter benefits
About the Company
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
P&C Claims Lead
Oakbrook Terrace, IL jobs
Full Time
Oakbrook Terrace, IL, US
Salary Range:$107,000.00 To $134,000.00 Annually
BCS Financial is seeking an experienced claims leader to oversee Specialty Risk Solutions claim operations and strategy for Agent E&O, commercial cyber, excess cyber, and other complex products. This role is responsible for managing day-to-day claims functions, driving process improvement, and collaborating across departments to ensure optimal claim outcomes and compliance.
Essential Elements
Adjudicate claims from end to end including assessing coverage, establishing reserves, communicating with Insureds, TPAs, coverage counsel and reinsurers, establishing reserves and negotiating settlements.
Establish and maintain early warning system to track and monitor Open claims (high-dollar, high risk exposure situations)
Facilitate Claims Committee, consisting of cross-functional areas with shared responsibility for positive claim outcomes and accurate financial reporting
Establish and report on key metrics (KPI and SLA performance management)
Analyze and report significant claim trends across programs (insourced and outsourced programs)
Coordinate and lead interdepartmental workflows and resources related to continuous process improvement efforts
Collaborate with underwriters to support policy construction and drafting, reporting claim trends, data analysis, and risk assessments
Participate and/or facilitate TPA audits, identify risks and work closely with Enterprise Risk Management and other internal teams to mitigate risks
Monitor reserves
Ensure great customer service experience for our Insureds
Perform similar work-related duties as assigned
Requirements
Education and Certifications
Bachelor's degree required; advanced degree or industry certifications (AIC, CPCU, RPLU) preferred.
Experience
10+ years of claims handling experience, with a focus on Agent E&O and Commercial Cyber claims.
Strong analytical, organizational, and process improvement skills.
Excellent verbal and written communication; able to present to senior management and in group settings.
Experience with claims management systems (e.g., Guidewire, ClaimCenter), data analytics, and reporting tools.
Knowledge of insurance industry claims process, legal/regulatory environment, and litigation/arbitration/trial processes.
Collaborative mindset and ability to influence others.
Travel Required
Local travel to main office
Client Service Team Lead, PC
Minneapolis, MN jobs
We are looking to add a Team Lead role on the PC Client Service Team in Minneapolis, MN. This is a great opportunity for someone looking to develop and grow their career in a leadership pathway. Team Lead responsibilities can apply to an AVP, PC; Sr. Client Service Consultant, PC; or Client Service Consultant, PC.
Following are the primary Team Lead responsibilities:
Lead and motivate team by:
Ensuring right talent is in the right role for the success of the organization, which may include hiring and terminating employees.
Coaching and counseling team members on areas such as workflow, process and procedure, customer service and client consulting.
Preparing and conducting performance feedback that defines future goals and objectives and holds employees accountable.
Fostering a high-performance culture by supporting career development and advancement for team members.
Responsible for timesheet management, including responding to PTO/RTO requests and approving timesheets.
Participate in compensation decisions for team members, as applicable.
Facilitate regularly scheduled meetings to foster teamwork.
Attend team and enterprise meetings, as well as leadership training opportunities offered internally and externally.
Coordinate initial and ongoing training with Growth & Development and team members on established processes and procedures.
Provide back-up assistance for team members, as necessary.
Qualifications:
Education: High school diploma; college degree preferred.
Licensing: Active state specific Property Casualty Insurance agent's license required or the ability to acquire license within three months of hire.
Experience: Minimum 5+ years customer service, underwriting, or risk management experience in the insurance industry.
Technical Competencies: Invests in understanding and applying insurance principles to consult with clients and meet their strategic needs. Actively contributes to workflows, processes, and deliverables, using agency systems to provide a world-class client experience and ensure compliance. Able to understand clients, prioritize tasks, manage status, and deliver impactful solutions proactively.
Here's a little bit about us:
In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.
Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:
Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first.
Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish!
Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?!
Holmes Murphy & Associates is an Equal Opportunity Employer.
Auto-ApplyTeam Lead, Doc Audit - First Mortgage
Moon, PA jobs
Are you eager to take command of your career and conquer exciting new challenges? ServiceLink, the unrivaled leader in the mortgage industry, is in search of a proven leader with demonstrated success and a sound knowledge base to fill the position of Team Lead, Doc Audit. The ideal candidate must possess a strong dedication to creating value for customers and rigorously promote our distinguished Serve First culture. If you thrive as an inspirational and motivating force behind high team performance, we encourage you to apply today. There may never be a better time to join ServiceLink, where the demand for exceptional commitment is rewarded with unlimited potential for self-directed growth.
**This is an in-office role, located at ServiceLink's corporate headquarters in Moon Twp., PA. Candidates must be within reasonable commuting distance of the Moon Twp., PA office and be willing and able to work in-office on a daily basis.
Applicants must be currently authorized to work in the United States on a full-time basis and must not require sponsorship for employment visa status now or in the future.
A DAY IN THE LIFE
In this role, you will…
· Process and review all closing related documentation to meet company, client, vendors and borrower requirements
· Be responsible for maintaining optimal levels of a Doc Audit Department including auditing incoming and outgoing client documentation packages and meeting the daily operational goals of a team within the department
· Serve as the primary contact within the team for any requests or issues
· Monitor and review employee time and attendance and conduct employee counseling sessions
WHO YOU ARE
You possess …
· Exceptional customer service skills
· A penchant for excellence. You will use your strong attention to detail to maintain our quality standards
· The ability to multitask in a fast paced environment, especially the ability to meet tight deadlines for our clients
· Excellent verbal and written communication skills
Responsibilities
· Review work-in-progress reports to ensure completion of assigned work for all team members
· Proficient in ServiceLink operating systems and internal search engines
· Communication with outside agencies, clients and borrowers
· Research and resolve discrepancies
· Print reports from established databases
· Maintain accurate records and logs
· Review all documentation for 100% accuracy
· Knowledge of client, vendor and borrower requirements
· Perform duties and responsibilities in a timely manner
· Maintain open communication with other team members and team leader
· Address inquiries from clients, borrowers, agents, and internal staff in a professional and timely manner
· Confirm team's adherence to client time requirements
· Take responsibility for the teams' accuracy, efficiency, timeliness, and completion of duties
· Monitor and review employee time and attendance and conduct employee counseling sessions as needed
· Make suggestions to assist with building and maintaining morale
· Identify and provide required training, i.e. one-on-one training, classes, and coaching for all team members
· Adhere to company policies and procedures
· Meet production goals and quality standards as set by management
· Perform all other duties as assigned
Qualifications
· High School diploma or equivalent preferred
· Typing/Data Entry skills, 45 wpm with a 95% accuracy rate
· Possess good communication and customer service skills
· Knowledge of Windows software applications
· Prior experience as a team member or experience in the real estate, banking, or vendor management industry
· Knowledge of real estate terminology
· Knowledge of real estate closing document recording process
· Must possess good organizational skills, ability to handle multiple tasks simultaneously
Auto-ApplyEmployee Benefits Account Management Team Lead
Houston, TX jobs
Higginbotham, a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an opening for an Employee Benefits Account Management Team Lead for our Houston, TX office.
This team lead will be responsible for assisting in workflow strategy development, deployment and training, collaborating with producers to oversee assigned team including workflows, workload, adherence to agency policies and procedures; also responsible for conflict resolution, performance reviews, expense management and salary administration for assigned team.
Essential Tasks:
Overall management and support of team and Office Advocates, if applicable
Interview and evaluate prospective team members
Coordinate training and guidance regarding department procedures
Assist in needs assessment and training where needed
Assist with back up, when necessary
Participate in disciplinary and termination issues
Assist with implementation of new procedures and/or changes
Ensure compliance with policies and procedures of team and Office Advocates, if applicable
Assists with cultivating efficient operations of the EB department within respective Region
Assist in resolving workflow issues as they arise
Remains abreast of employee benefits insurance markets
Participates in staff recognition
Audit development, implementation and oversight
For Team Leaders with assigned book of business, the following also apply:
Acts as primary contact between client, prospect, agency, and producer; represents the agency in handling complaints, arbitrating disputes, or resolving grievances.
Handles or refers all service requests by our clients
Initiates and handles marketing of account beginning 120 days prior to renewal date. Gathers the necessary information regarding new/existing accounts and submits this information to the various and appropriate carriers to obtain proposals; investigate carrier products, analyzes and reviews clients' data to appropriate carriers to recommend appropriate plans and proposals to offer the client.
Reviews the proposals received for accuracy, works hand in hand with Producer to generate proposal presentation through spreadsheets and proposal exhibits
Calculates premium and payroll deductions, audit billing statements for accuracy on behalf of clients
Generates open enrollment material i.e. enrollment guides, election forms, personalized confirmation sheets, enrollment/change forms, power point presentations for client presentations
Conducts open enrollment presentations in front of an audience
Processes necessary paperwork for submission to carrier
Directs a smooth transition from one carrier to another
Updates all accounts, timely, to maintain files on the agency management systems
Sets priorities and manages workflow to ensure efficient, timely and accurate processing of transactions and other responsibilities.
Maintains knowledge of new developments or changes with the various carriers and new Federal/State laws that may affect how our clients must administer their benefit programs, and communicate this information to clients and team members
Develops and maintains a positive relationship and rapport with each insurance carrier to satisfy our clients' needs and facilitate the processing of business
Non-essential Tasks:
Attends and completes any training sessions or assignments as required
Performs other related tasks as needed
Specific Knowledge, Skills and Abilities:
Highly motivated self-starter with ability to work independently to accomplish established agency goals
Ability to work as a team player with a committed positive approach to working through adversity
Strong organizational and time management skills, with an extreme attention to detail
Critical thinking skills with ability to use logic and reasoning to identify deficiencies or other concerns
Ability to adhere to and meet deadlines
Above average mathematical skills
Accountable and delivers on commitments
Exceptional communication skills, both in the verbal and written word, necessary to communicate with clients, carriers and prospects concerning employee benefit lines of coverage
Intermediate knowledge of Microsoft Office Products Outlook, Word and Excel preferred; basic working knowledge of Power Point preferred
Experience and Education:
High school diploma or equivalent
Life and Health Agent's license
Minimum four years' experience in account management preferred
ACSR designation preferred
Commitment to continuous learning
Location:
Houston, TX
Physical Requirements:
Ability to lift 25 pounds
Repeated use of sight to read documents and computer screens
Repeated use of hearing and speech to communicate on telephone and in person
Repetitive hand movements, such as keyboarding, writing, 10-key
Walking, bending, sitting, reaching and stretching in all directions
Team Marques Future Start Date
Westerville, OH jobs
We are seeking a Licensed Insurance Agent to assist individuals in navigating Medicare programs. In this role, you will educate clients on Medicare options (Parts C & D as well as Med Supp/MediGap and ancillary products), recommend suitable plans based on their needs, and help with enrollment and transitions between plans.
Job Responsibilities
Educate clients about Medicare benefits and coverage options.
Assist with plan enrollment and transitions.
Conduct plan comparisons and provide recommendations.
Ensure compliance with Medicare regulations and deadlines.
Effectively manage inbound and outbound calls in a high-volume sales environment, while maintaining professionalism and accuracy.
Maintain accurate records and documentation.
Provide excellent customer service to resolve issues and answer questions.
Minimum Qualifications
Holds valid health insurance license.
Can provide proof of release or intent to release if previously or currently appointed elsewhere.
Current plan year AHIP certification.
Understanding of sales and ability to generate revenue.
Capability to contract and become RTS (ready-to-sell) with multiple insurance carriers (3 main MAPD carriers or 2 main MAPD carriers and one approved secondary carrier.)
Main MAPD carriers: United Healthcare, Humana, Aetna
Secondary carriers: Cigna, Anthem, Wellcare, Zing, Devoted
Comfortable operating in a metrics-driven environment with expectations around sales performance, and call compliance.
Ability to work in compliance with CMS Federal regulations.
Strong organizational, interpersonal, communication, and presentation skills.
Must be authorized to legally work in the United States without sponsorship.
If you are a licensed, highly motivated individual who shares our core values, has a passion for helping Medicare-eligible seniors, and a drive for sales success, we encourage you to apply and become part of the Exact Medicare team!
Team Lead-Retail
Park City, UT jobs
WHAT WE'RE LOOKING FOR? The Team Lead links the leadership team and the sales associates by assisting in the operational functions of the store, and motivating the team to exceed goals. Reporting directly to the Store Manager, the Team Lead provides support and coverage to the Store and Assistant Managers in their absence. They model desired selling and customer service behaviours at all times to promote an environment focused on consistent, exceptional and positive in-store experience to customers and employees.
To be successful, you'll need to possess:
1 + years related experience in a retail apparel environment, luxury retail experience is a plus;
Proven ability to successfully lead a sales team; viewed as a leader among peers;
Proven experience with POS management, daily banking procedures, and submitting timely reports;
Strong organization, and problem solving skills;
Passion for upholding an exceptional customer experience;
Collaborate with others, yet be self-motivated;
Available for varied weekly shifts, including weekends, closing and holidays.
THE IMPACT YOU'LL HAVE
This is an opportunity to shape our company's future by:
Demonstrate a customer obsessed selling culture and build brand loyalty through excellent product knowledge;
Partner with store management to execute action plans that optimize results and ensure effective execution of all store operational activities;
Contributes ideas and solutions to the leadership team that results in increased productivity and improved operations of the store;
Assist store management in conducting new associate onboarding and trainings;
Coaches associates on customer service fundamentals and provides positive feedback;
Assists in resolving customer service matters;
Oversees and delegates tasks to team to best maximize efficiency of store operations;
Communicates individual and/or team performance feedback to store management;
Ensure team receives scheduled breaks and/or meal periods;
Creates an open outward communication on the sales floor;
Ensure adherence to all company policies, procedures and guidelines;
Perform opening and closing procedures, and any inventory duties as directed.
WHY JOIN ROOTS? Roots is not only a brand, it's a culture and lifestyle. We look for dynamic individuals who are not only interested in retail and fashion, but who enjoy challenges and share our vision for a safer, cleaner, healthier planet.
In addition to our customers, an intrinsic part of our success has always been the people who work here. Roots is a company in which you can grow and benefit from the great opportunities often available. All members of our team are encouraged to 'spread their roots'.
SOUND LIKE YOU? APPLY NOW!
We'd like to thank everyone who applies, but we can only contact applicants who are most qualified.
Appeals Clinical Team Lead
Salem, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Essential Responsibilities:
Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions.
Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks.
Responsible for the orientation and training of new hires.
Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees.
Participate in hiring decisions in concert with Appeals and Grievance Director and HR.
Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.
Utilize and promote use of evidence-based medical criteria.
Maintain modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers.
Provide backup to other departmental teams or management staff, as needed.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information.
Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations.
Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director.
Perform other duties as assigned.
Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed.
Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyMedicaid Care Manager Team Lead Registered Nurse
New York, NY jobs
Department: CASE MANAGEMENT Job Type: Regular Employment Type: Full-Time Salary Range: $123,588.00 - $123,588.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
Under the direction of the Director of Medicaid, the Medicaid Care Manager Team Lead ensures that staff adhere to the Medicaid contractual requirements, policies and procedures, and workflows established to manage the vulnerable Medicaid population.
The Medicaid Care Manager Team Lead manages the daily activities of the Medicaid team (Care Managers and Care Management Associates) to ensure quality outcomes in the delivery of member-centered case management including reduction in emergency room visits and hospital admissions, improved member satisfaction, improved member health, and cost effectiveness.
Work Shifts
9:00 A.M - 5:00 P.M
Duties & Responsibilities
* Provide clinical guidance and supervision to assigned Care Managers and clinical support staff to promote efficient and effective delivery of care management services
* Supervise day to day activities to make certain that case management services are provided in accordance with clinical guidelines, established processed and MetroPlusHealth organizational standards.
* Supervise the entire care management workflow including case referrals, assignments, interventions and goal setting, follow-up/follow-through activities, documentations, and escalations.
* Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care.
* Review, develop and modify day to day workflows to ensure timely follow up.
* Perform ongoing quality review of cases to ensure accuracy and compliance.
* Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performances.
* Utilize data to track, trend and report productivity and outcome measures, work with the management team to implement necessary improvement strategies.
* Coordinate Interdisciplinary Care Team rounds with providers, care managers and care management associates, this include scheduling meetings, identifying members for presentation, and ensuring completion and documentation of follow up activities.
* Collaborate Behavioral Health to develop strategies and best practices that lead to desired goals and objectives for members who are co-managed.
* Use expert verbal and non-verbal communication skills to motivate and gain co-operation of members and their caregivers.
* Resolve issues and mitigate conflict encountered during daily operations, appropriately escalate issues to the Director of Medicaid
* Identify and report potential risk, operational opportunities, and barriers encountered.
* Conduct monthly audits for the purpose of departmental/organizational reporting and providing formal feedback to case management staff.
* Create and submit operational weekly/monthly/quarterly reports.
* Work with the leadership team to develop and implement ongoing training and development efforts.
* Actively participate in staff training and meetings.
* Encourage regular communication and inform staff of relevant departmental and organizational updates.
* Develop and maintain collaborative relationships with clinical providers, facility staff and community resources.
* Ensure staff comply with orientation requirements, annual and other mandatory trainings, organizational and departmental policies, and procedures.
* Perform other duties as assigned by Director.
Minimum Qualifications
* Bachelor's Degree required, Master's in nursing preferred.
* A minimum of 5 years of Care Management experience in a health care and/or Managed Care setting required.
* Minimum of 2 years managerial/leadership experience in a Managed Care and/or healthcare setting required.
* Proficiency with computers navigating in multiple systems and web-based applications.
* Must know how to use Microsoft Office applications including Word, Excel, and PowerPoint and Outlook.
* Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions required
* Valid New York State license and current registration to practice as a Registered Professional Nurse (RN) Issued by the New York State Education Department (NYSED).
* Integrity and Trust
* Customer Focus
* Functional/Technical Skills
* Confident, autonomous, solution driven, detail oriented, nonjudgmental, diplomatic, resourceful, intuitive, dedicated, resilient and proactive.
* Strong verbal and written communication skills including motivational coaching, influencing, and negotiation abilities.
* Holds themselves to high standards of excellence
* Time management and organizational skills.
* Strong problem-solving skills.
* Ability to prioritize and manage changing priorities under pressure.
* Ability to work closely with member and caregiver.
* Ability to form effective working relationships with a wide range of individuals.
#MPH50
#LI-Hybrid
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
* Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
* Retirement Savings and Pension Plans
* Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
* Loan Forgiveness Programs for eligible employees
* College tuition discounts and professional development opportunities
* College Savings Program
* Union Benefits for eligible titles
* Multiple employee discounts programs
* Commuter Benefits Programs
Appeals Clinical Team Lead
Bend, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Essential Responsibilities:
Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions.
Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks.
Responsible for the orientation and training of new hires.
Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees.
Participate in hiring decisions in concert with Appeals and Grievance Director and HR.
Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.
Utilize and promote use of evidence-based medical criteria.
Maintain modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers.
Provide backup to other departmental teams or management staff, as needed.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information.
Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations.
Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director.
Perform other duties as assigned.
Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed.
Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyEnrollment and Billing Team Lead
Bend, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Supervise and provide guidance to the Government Enrollment and Billing team regarding company and department policies, procedures and workflow. Set goals and implement strategies to ensure internal processes are current and metrics are met. Coach team members to improve individual performance and develop teamwork.
Essential Responsibilities:
Maintain broad knowledge of all job positions assigned to team lead and provide supervision, training, evaluation and leadership to assigned staff.
Evaluate performance of team members. Analyze results of performance reports to determine staffing and training needs related to department goals. Provide feedback, including regular one-on-one meetings with direct reports. Conduct and submit performance evaluations on a timely basis.
Have a thorough understanding and use of the eligibility and member billing operation systems (EAM and EMS). Maintain workload in these specialty areas.
Provide and/ or oversee training and orientation of new hires. Develop programs to assure ongoing training and coaching to new and current membership staff.
Understand all applicable CMS and HPMS regulations and have the ability to educate internal and external customers. Investigate and settle issues within contract guidelines as needed. Relay information for dispute resolution to appropriate departments and personnel.
Understand all applicable OHA and OAR regulations and have the ability to educate internal and external customers.
Ensure all direct reports understand processes from end-to-end and assist with gaps as needed.
Assist with answering inquiries from members as well as conduct auditing of member accounts, verifying the validity of any past-due accounts and the delinquent letter process to Medicare members.
Ensure that all member-billing issues are submitted to business partners/vendors.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Serve on various interoffice committees. Document and report any pertinent communication back to the manger, team or other.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Assist with process improvement and work with other departments to improve interdepartmental processes.
Utilize lean methodologies for continuous improvement opportunities. Use visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Assist the manager with daily operations including the development, analysis and implementation of policies and procedures, training, reporting and recognition programs.
Actively participate as a key team member while creating and supporting a high-quality work environment to encourage a high performance.
Provide backup for any of the department tasks that may become backlogged, have compliance risks or have other reasons for being unworkable by staff.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Support and participate in continuous improvement initiatives.
Maintain professional, service oriented relationships.
Ability to judge severity of problems and the need to escalate to management or employ external services.
Perform other duties as assigned.
Work Experience: Minimum of four years administrative experience in the health care industry, including two years in enrollment and billing in insurance. Supervisory experience preferred.
Education, Certificates, Licenses: Associates degree or equivalent combination of experience and education.
Knowledge: Effective written and oral communication. Ability to read and communicate policy and contract language. Demonstrated time management, critical thinking and problem solving skills. Ability to understand and interpret Federal and State regulations. Advanced proficiency in Microsoft Office Applications. Excel skills should include formulas, sorts, filters, VLOOKUP, IF statements, etc. Requires the ability to clearly articulate problem statements, collect data and establish facts.
Competencies:
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyAppeals Clinical Team Lead
Portland, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Essential Responsibilities:
Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions.
Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks.
Responsible for the orientation and training of new hires.
Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees.
Participate in hiring decisions in concert with Appeals and Grievance Director and HR.
Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.
Utilize and promote use of evidence-based medical criteria.
Maintain modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers.
Provide backup to other departmental teams or management staff, as needed.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information.
Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations.
Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director.
Perform other duties as assigned.
Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed.
Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyFinancial Protection Contact Center, Team Leader
Pittsfield, MA jobs
In this role, you will be at the heart of our Contact Center's day-to-day operations, leading an award-winning team to deliver remarkable service. You will drive colleagues to achieve world-class customer service while adhering to our Guardian Values.
You are
Experienced in leading and inspiring teams
Skilled in managing operational processes
Passionate about customer service excellence
Skilled at encouraging a collaborative and inclusive environment
You will
Lead and manage daily business operations
Mentor and develop frontline colleagues
Analyze and resolve root-cause service issues
Communicate performance updates to senior leadership
You have
BA/BS degree preferred or equivalent experience
Three plus years of insurance, or other financial service industry experience, preferred
Proven leadership and analytical skills
Strong ability to prioritize and manage tasks
Proficiency in Microsoft products
Location & Travel
Bethlehem, PA or Pittsfield, MA
Hybrid work arrangement
Salary Range:
$67,450.00 - $110,815.00
The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
Our Promise
At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Inspire Well-Being
As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at ************************************************
Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.
Equal Employment Opportunity
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
Accommodations
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com.
Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.
Auto-ApplyEnrollment and Billing Team Lead
Boise, ID jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Supervise and provide guidance to the Government Enrollment and Billing team regarding company and department policies, procedures and workflow. Set goals and implement strategies to ensure internal processes are current and metrics are met. Coach team members to improve individual performance and develop teamwork.
Essential Responsibilities:
Maintain broad knowledge of all job positions assigned to team lead and provide supervision, training, evaluation and leadership to assigned staff.
Evaluate performance of team members. Analyze results of performance reports to determine staffing and training needs related to department goals. Provide feedback, including regular one-on-one meetings with direct reports. Conduct and submit performance evaluations on a timely basis.
Have a thorough understanding and use of the eligibility and member billing operation systems (EAM and EMS). Maintain workload in these specialty areas.
Provide and/ or oversee training and orientation of new hires. Develop programs to assure ongoing training and coaching to new and current membership staff.
Understand all applicable CMS and HPMS regulations and have the ability to educate internal and external customers. Investigate and settle issues within contract guidelines as needed. Relay information for dispute resolution to appropriate departments and personnel.
Understand all applicable OHA and OAR regulations and have the ability to educate internal and external customers.
Ensure all direct reports understand processes from end-to-end and assist with gaps as needed.
Assist with answering inquiries from members as well as conduct auditing of member accounts, verifying the validity of any past-due accounts and the delinquent letter process to Medicare members.
Ensure that all member-billing issues are submitted to business partners/vendors.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Serve on various interoffice committees. Document and report any pertinent communication back to the manger, team or other.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Assist with process improvement and work with other departments to improve interdepartmental processes.
Utilize lean methodologies for continuous improvement opportunities. Use visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Assist the manager with daily operations including the development, analysis and implementation of policies and procedures, training, reporting and recognition programs.
Actively participate as a key team member while creating and supporting a high-quality work environment to encourage a high performance.
Provide backup for any of the department tasks that may become backlogged, have compliance risks or have other reasons for being unworkable by staff.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Support and participate in continuous improvement initiatives.
Maintain professional, service oriented relationships.
Ability to judge severity of problems and the need to escalate to management or employ external services.
Perform other duties as assigned.
Work Experience: Minimum of four years administrative experience in the health care industry, including two years in enrollment and billing in insurance. Supervisory experience preferred.
Education, Certificates, Licenses: Associates degree or equivalent combination of experience and education.
Knowledge: Effective written and oral communication. Ability to read and communicate policy and contract language. Demonstrated time management, critical thinking and problem solving skills. Ability to understand and interpret Federal and State regulations. Advanced proficiency in Microsoft Office Applications. Excel skills should include formulas, sorts, filters, VLOOKUP, IF statements, etc. Requires the ability to clearly articulate problem statements, collect data and establish facts.
Competencies:
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyAppeals Clinical Team Lead
Boise, ID jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Essential Responsibilities:
Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions.
Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks.
Responsible for the orientation and training of new hires.
Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees.
Participate in hiring decisions in concert with Appeals and Grievance Director and HR.
Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.
Utilize and promote use of evidence-based medical criteria.
Maintain modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers.
Provide backup to other departmental teams or management staff, as needed.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information.
Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations.
Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director.
Perform other duties as assigned.
Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed.
Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyEnrollment and Billing Team Lead
Springfield, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Supervise and provide guidance to the Government Enrollment and Billing team regarding company and department policies, procedures and workflow. Set goals and implement strategies to ensure internal processes are current and metrics are met. Coach team members to improve individual performance and develop teamwork.
Essential Responsibilities:
Maintain broad knowledge of all job positions assigned to team lead and provide supervision, training, evaluation and leadership to assigned staff.
Evaluate performance of team members. Analyze results of performance reports to determine staffing and training needs related to department goals. Provide feedback, including regular one-on-one meetings with direct reports. Conduct and submit performance evaluations on a timely basis.
Have a thorough understanding and use of the eligibility and member billing operation systems (EAM and EMS). Maintain workload in these specialty areas.
Provide and/ or oversee training and orientation of new hires. Develop programs to assure ongoing training and coaching to new and current membership staff.
Understand all applicable CMS and HPMS regulations and have the ability to educate internal and external customers. Investigate and settle issues within contract guidelines as needed. Relay information for dispute resolution to appropriate departments and personnel.
Understand all applicable OHA and OAR regulations and have the ability to educate internal and external customers.
Ensure all direct reports understand processes from end-to-end and assist with gaps as needed.
Assist with answering inquiries from members as well as conduct auditing of member accounts, verifying the validity of any past-due accounts and the delinquent letter process to Medicare members.
Ensure that all member-billing issues are submitted to business partners/vendors.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Serve on various interoffice committees. Document and report any pertinent communication back to the manger, team or other.
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Assist with process improvement and work with other departments to improve interdepartmental processes.
Utilize lean methodologies for continuous improvement opportunities. Use visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Assist the manager with daily operations including the development, analysis and implementation of policies and procedures, training, reporting and recognition programs.
Actively participate as a key team member while creating and supporting a high-quality work environment to encourage a high performance.
Provide backup for any of the department tasks that may become backlogged, have compliance risks or have other reasons for being unworkable by staff.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Support and participate in continuous improvement initiatives.
Maintain professional, service oriented relationships.
Ability to judge severity of problems and the need to escalate to management or employ external services.
Perform other duties as assigned.
Work Experience: Minimum of four years administrative experience in the health care industry, including two years in enrollment and billing in insurance. Supervisory experience preferred.
Education, Certificates, Licenses: Associates degree or equivalent combination of experience and education.
Knowledge: Effective written and oral communication. Ability to read and communicate policy and contract language. Demonstrated time management, critical thinking and problem solving skills. Ability to understand and interpret Federal and State regulations. Advanced proficiency in Microsoft Office Applications. Excel skills should include formulas, sorts, filters, VLOOKUP, IF statements, etc. Requires the ability to clearly articulate problem statements, collect data and establish facts.
Competencies:
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyAppeals Clinical Team Lead
Springfield, OR jobs
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Essential Responsibilities:
Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions.
Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks.
Responsible for the orientation and training of new hires.
Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees.
Participate in hiring decisions in concert with Appeals and Grievance Director and HR.
Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate.
Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.
Utilize and promote use of evidence-based medical criteria.
Maintain modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers.
Provide backup to other departmental teams or management staff, as needed.
Supporting Responsibilities:
Meet department and company performance and attendance expectations.
Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information.
Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations.
Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director.
Perform other duties as assigned.
Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed.
Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
Auto-ApplyFloating Team Lead Cleaner - Full Time, WEEKLY PAY
Grand Rapids, MI jobs
United Commercial Services is a trusted leader in facility cleaning, proudly serving clients across Michigan for over 20 years. We're committed to providing high-quality service while supporting our team members with steady, reliable employment and room to grow.
Job Skills / Requirements
Details
Schedule: Monday - Friday 5pm-1am with occasional weekends
Pay: $17 hourly; weekly pay
Before You Start: Qualified candidates will have previous commercial cleaning experience and a strong background in team leadership or supervision. Must be reliable, able to work independently, and confident leading others. A background check is required.
Location: Downtown Grand Rapids (Multiple Locations)
Primary Duties (Including but Not Limited To)
Cleaning Floors: Vacuuming, sweeping, and mopping designated areas to maintain cleanliness.
Operating Equipment: Using floor scrubbers and other tools effectively for thorough cleaning.
Detail Cleaning: Ensuring all surfaces are properly cleaned using appropriate equipment and chemicals.
Trash Disposal: Collecting and disposing of trash to keep work areas tidy.
Workspace Maintenance: Keeping designated areas clean and well-maintained.
Communication: Reporting low cleaning supplies and equipment issues to supervisors.
Equipment Oversight: Notifying supervisors of any major equipment repairs needed.
Timely Task Completion: Completing assigned tasks promptly and efficiently.
Restroom Cleaning: Cleaning and restocking restrooms to uphold hygiene standards.
Team Leadership: Leading by example and providing guidance to team members, ensuring tasks are completed according to company standards and fostering a positive work environment.
Requirements
Age Requirement: Minimum of 18 years old.
Legal Authorization: Must be legally permitted to work in the US.
Background Check: Ability to pass a criminal background check per location requirements
Transportation: Must have reliable transportation to and from work.
Time Management: Ability to manage time effectively to meet job responsibilities.
Physical Ability: Capable of lifting at least 25 pounds.
Maintenance Skills: Proficiency in handling basic maintenance, repairs, or other cleaning duties as required.
Teamwork: Able to work independently or collaboratively as part of a team.
Communication: Effective verbal and written communication skills.
Flexibility: Willingness to perform additional duties as assigned by supervisors
This job reports to the Manager
This is a Full-Time position 2nd Shift, Weekends.
Assistant Team Leader
Ames, IA jobs
Mainstream Living provides services designed to enhance opportunities, create success and fulfill dreams. The purpose of the ATL position is to provide services and supports in community residential settings to persons with intellectual disabilities and brain injuries. This position is a professional position which provides assistance and support to Team Leader through a combination of direct support services to members, assisting with oversight of Direct Support Professional (DSP) and completion of administrative tasks. All personnel are expected to promote a safe and welcoming environment that inspires hope and supports members with their individual goals and aspirations.
QUALIFICATIONS AND SKILLS
Education: High School Diploma or Equivalency/HiSet/GED
Experience: Human Service Experience is strongly preferred.
Driving: This position requires possession of valid Driver's License, legal driving privileges and
ability in the State of Iowa and qualification with Mainstream Living's underwriter as an insurable driver.
Computer: Basic data entry skills required. Familiarity with WORD, Google Docs, Excel is preferred.
Post hire: Must demonstrate competencies to complete internal training, including training to
pass medication.
General: All employees must work diligently to incorporate the spirit and intent of the agency mission,
vision and values. This includes respectful communication to all others at all times. Employees must
be able to establish a rapport and develop positive relationships with others while conducting self in
line with the Agency Code of Ethics. Employees must also demonstrate consistent professional
Conduct and establish and maintain appropriate boundaries with others; take accountability for own work while demonstrating a willingness to accept responsibility and offer constructive recommendations; demonstrate dependability and flexibility when shift times or duties of the day change; apply common sense to carry out instructions furnished in written or oral form; and ensure that the best interest of the members are a top priority at all times.
The Assistant Team Leader position requires good attention to detail and superior organizational skills. Excellent communication and interpersonal skills are required, with ability to listen effectively, respond appropriately, and maintain mutual comfort level while relating to diversity. Must have the ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Have the ability to interpret a variety of instructions, furnished in written, oral, diagram, or schedule form.
The Assistant Team Leader is a leadership position. This individual must be a stable, mature, professional person capable of working in stressful situations. Must possess good judgment in crisis situations and demonstrate the same. The Assistant Team Leader must be flexible, and able to collaborate with the team to develop strategies and systems that resolve problems. This person must be able to objectively examine situations and determine appropriate courses of action.
The Assistant Team Leader must both serve as a role model for members and DSP staff; and act as a role model for the company by maintaining positive and professional relationships with members, guardians, staff, case managers and other stakeholders regarding direct service and specific needs of the member.
ESSENTIAL DUTIES AND RESPONSIBILITIES
This position is considered an essential health care worker position and in the event of an emergency may be required to work one-on-one with members to ensure their safety.
General Administrative Duties:
* Participate in interviewing, welcoming, onboarding and initial training of new employees as assigned. Assist in ongoing training relevant to program or member-specific needs.
* Primary responsibility for completion of staff work schedule, ensuring that all shifts are covered.
* Proactively train fill-in or PRN staff so that a back up list can be developed.
* Work with the existing staff team to brainstorm coverage, shift switches or tweaking shift hours to help with absence coverage and reduce overtime.
* Communicate difficulties with schedule and/or shift coverage to the supervisor for assistance, with as much notice as possible.
* Communicate information regarding status changes, transfer requests, terminations, or leaves to TL and appropriate personnel. Complete and submit Personnel Action forms.
* Work collaboratively with Human Resources and Team Leader to address open hours.
* Approve DSP timecards, monitoring for accuracy, overtime reduction and as outlined by policy. Communicate with peers to confirm accuracy of time worked by DSP at sites on other caseloads.
* Monitor DSP performance when on site. Provide feedback when necessary and communicate observations and issues to Team Leader.
* Employ systems to monitor member personal budgets and expenses as outlined by policy; complete banking reconciliation and provide receipts as required. Monitor onsite money count systems for accuracy and completion.
* Check medication areas and follow up on any medication errors, organizational issues, outdated medication, drug destruction, etc.
* Code, approve and submit employee expense reimbursements and agency vehicle mileage.
* Monitor sites for safety and maintenance needs. Receive and complete maintenance requests and monitor and communicate delays or issues.
* Complete site visits as assigned.
* Ensure routine checks, emergency drills, lift reviews etc. are completed and submitted.
* Monitor vehicle cleanliness, supplies and incidents. Schedule 6 mos and nonroutine maintenance checks.
* Assist with oversight of DSP staff and assume primary responsibility for the Team Leader caseload in the absence of the Team Leader.
* Complete member paperwork in a thorough and timely fashion including but not limited to Section 8, camps, food stamps, activities, etc.
* Provide backup assistance if TL is absent.
* Other duties as assigned.
Member and Direct Service Related:
Maintain weekly balance of direct care shifts as instructed by supervisor. Direct care assignments may fluctuate depending on open shifts and need, but to the degree possible the ATL direct hours should be on their own caseload. When completing direct care duties, ATL will complete duties as outlined on the DSP providing exemplary services and acting as a role model to DSP workers by:
* Monitoring safety and cleanliness of member living environments; communicating needs or concerns to TL or Maintenance.
* Monitoring the medical, medication and nutritional needs of members and reporting suggestions or concerns to TL
* Assist in the implementation and monitoring of members' service plan into daily routine by providing direct support, supervision and encouragement according to their established supports and individualized goals.
* Assist in assessing member skills/needs and interests. Communicate observations and suggestions to TL, and the members' interdisciplinary team as needed.
* Assist in the development, implementation and documentation of member specific training activities as assigned.
* Communicate effectively and professionally with guardians, stakeholders and others.
* Assist in the implementation and monitoring of member behavioral support plans.
* Assist with member education, forums and meetings.
Adherence to Policies and Procedures:
All employees will adhere to agency policies and procedures including but not limited to:
* Personnel Policies and Policy manuals.
* Attend and work shifts as scheduled. Adhere to agency Attendance Policies for time off, on-call and attendance to training/staff meetings.
* Follow medication and medical policy and procedures to include: administration, record keeping, identification of medication, purpose, therapeutic intent and adverse reactions, and self-administration of medication.
* Follow documentation procedures to include accurate, honest and timely completion.
* Follow health and safety practices per agency policies including participation in emergency procedures, drills, proper infection control, accident/injury prevention, etc.
* Follow vehicle policies for safe operation of agency vehicles and safe transport of members/others if in driving position.
* Keep supervisor informed of critical and non-routine events. Communication is constructive, effective, and timely.
WORK ENVIRONMENT
The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made upon request to enable employees with a disability to perform the essential functions.
Physical Demands: While performing this job, employees must be able to meet the physical demands required to complete essential functions of this position and meet member needs in their home environment. Employees will be required to lift 15-25 pounds on a frequent basis. Depending on member needs and in some work locations, employees may be required to assist with ambulation, lifting and transferring of members, generally with the use of adaptive equipment such as gait belts, walkers, wheelchairs, mechanical lifts, etc. Thus, there may be times the employee must lift up to 50lbs and rarely up to 100lbs if working in sites with members requiring ambulation assistance.
OSHA CLASSIFICATION
This position is considered a Classification I in regard to jobs in which required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues or potential spills or splashes. Additionally, there is possible exposure to cleaning chemicals. Use of appropriate measures is required for every health care provider.
We are pleased to provide eligible employees with fantastic benefits which include:
* Health, vision, and dental insurance
* 403(b) retirement plan with match
* Paid time off including vacation, holidays and sick time
* Regular wage increase evaluation
* Training and development opportunities
* Education grants
* Life insurance, cancer coverage, and flexible spending accounts
* Opportunities for bonuses/incentives and internal recognition programs
Full job description provided at time of interview.
EOE
Commercial Lines Team Leader - Southeast Region
Gainesville, FL jobs
Job DescriptionDescription:
Candidates must be located in the Southeast region and have an active P&C License
(North Carolina, South Carolina, Georgia,Tennessee, Mississippi)
At King Risk Partners, LLC, we're dedicated to providing top-tier insurance solutions to our clients while fostering a positive and collaborative work environment. As a growing leader in the insurance industry, we're excited to welcome new team members who share our commitment to excellence.
As we continue to expand our presence and reputation within the insurance sector, we recognize that the cornerstone of our success is the expertise and dedication of our team members. We're eager to welcome individuals who are not only passionate about insurance but also excited to contribute their unique skills and perspectives to our dynamic and driven team.
If you're enthusiastic about making a meaningful impact in the insurance industry, and if you're ready to be part of a team that values dedication, innovation, and client satisfaction, we invite you to explore the exciting opportunities that await you at King Risk Partners, LLC. Together, we can continue to redefine excellence in insurance services and create a legacy of success.
Requirements:
Provides guidance and support to Commercial Account Managers.
Assign daily tasks and set expectations for team members.
Train, coach, and guide team members on performance and room for improvement.
Works closely with the Managing Director to ensure support is provided to the Commercial Account Executive.
Provides support to AM, AE or Producer in the new business and renewal business workflows, including but not limited to:
Client research and gathering complete underwriting information.
Conducting Loss Run Analysis.
Preparing complete and accurate submissions including Acord applications and/or supplemental forms; sending out to market and/or performing Online Rating as required.
Binding coverage and complying with any subjectivity(ies) as required by carrier, Surplus Lines Association and/or King Insurance Partners.
Review all policies, identifying and notifying AM, AE or Producer of any discrepancies and ensuring that all necessary. changes are submitted to and issued by the carrier.
Growing client loyalty by building positive relationships and providing high levels of advocacy, world-class service, and professional communication.
Ability and willingness to continually grow your insurance expertise, management/leadership skills, and followership skills.
All other duties as assigned.
Knowledge, Skills and Abilities (KSA):
Exceptional customer service skills.
Excellent multi-tasking, organizational, delegation and decision-making skills.
Outstanding verbal/written communication skills.
Ability to perform large work volumes with high degrees of accuracy.
PC proficiency, including MS Office.
Exceptional personal character, including a strong work ethic, positive attitude, and willingness to always assist others.
Required:
2+ years of supervisory experience.
5+ years of commercial lines insurance agency/brokerage experience.
2+ years recent experience using AMS360.
An active P&C license.
What We Offer:
Medical Insurance
Dental Insurance
Vision Insurance
401(k) with employer match
Short-Term Disability (employer paid)
Long-Term Disability (employer paid)
Life Insurance
Employee Assistance Program
Generous PTO Policy
Tuition Reimbursement
Employee Referral Program
Growth and advancement opportunities
Equal Opportunity Employer
King Risk Partners, LLC is proud to be an equal opportunity employer. We encourage applications from candidates of all backgrounds and experiences.
Join us in making a difference in the insurance industry.