Member Service Specialist in California

The Member Services Specialist role is an integral part of the GOVX Customer Operations success, providing a mix of direct-to-consumer support and partner success in a helpdesk-style fashion. Guiding, teaching, and leading our Member Services and operations to success with their service interactions through process, product, quality assurance and escalation support. The role supports the day-to-day business through the support of the expert teams, vendor partners and the overall operations by shifting gears from floor leader to project support, to front line ticket support as business needs dictate.   

Work Location:  In office at San Diego, CA location.

Roles and Responsibilities

• Support a shift of Experts through “helpdesk” style support for product, process, operations, logistics, & escalation.
• Provide direction, guidance, and training as needed to support day-to-day operational...

POSITION SUMMARY

Drives customer loyalty and provides excellent telephonic customer service to our customers (members and providers). This position will work with other departments in order to respond to customer and provider concerns in a timely and effective manner.

COMPLIANCE WITH REGULATIONS:

Works closely with all departments necessary to ensure that the processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations including CMS and/or Medicare Part D, DHCS and DMHC.

Requirements

RESPONSIBILITIES

• Effectively resolve member concerns through a range of strategic actions.
• Coordinating swift and seamless urgent care access, interpreter services, and transportation arrangements.
• Facilitating smooth transitions for...