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Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Supervisor Health Plan Operations, Commercial - Customer Service who will:
- Lead a professional team of Customer Service Agents responsible for servicing Member and Provider telephone, chat and email inquiries
- Possess a well-rounded and diverse level of product expertise for the Commercial (Full Risk) line of business
- Demonstrate knowledge and expertise with supporting:
- Quality Improvement initiatives
- Resolution of claims and enrollment issues
- Rapid identification of customer service production and resource issues related to resource and staffing deficiencies
- Possess a strong working knowledge of applicable regulatory requirements regarding:
- Accurate and timely claims processing
- State, Federal and Regulatory inquiry response times
- Member enrollment and materials distribution
- Member status change transactions
- Group and individual premium billing
- Premium reconciliation
- Delinquency and collection processes
- Foster effective working relationships with vendors, consultants and other PHP staff in performing their duties
- Perform a key leadership role in providing a supportive, team-based environment
We welcome 100% remote work for residents who reside in one of the following areas:
- Oregon: Clackamas, Multnomah and Washington Counties
- Washington: Clark County
Required qualifications for this position include:
- Bachelor's Degree in Business Management, Healthcare Administration, Accounting, or another related field of study and 4+ years of management/industry experience -OR- Associate Degree and 6+ years of related management / industry experience -OR- a minimum of a HS Diploma / GED Equivalency and 8+ years of related management / industry experience
Preferred qualifications for this position include:
- 1+ years of customer service background in managed care environment
- 1+ years of experience navigating Behavioral Health benefits and policies
- Experience in project management methods
Why Join Providence?
Ourbest-in-class benefitsare uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering ourMissionof caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 268538
Company: Providence Jobs
Job Category: Member Services Enrollment & Billing
Job Function:Health Plans Services
Job Schedule: Full time
Job Shift: Day
Career Track: Leadership
Department: 5018 OPS CUST SERVICE COMMERCIAL OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $32.98 - $52.20
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
