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Serves the needs of shareholders. This position is typically an elected position. Attends board meetings. Votes on various matters. Serves on various committees.: Likely unpaid for service if an inside member who also serves as a member of management. As an outside board member, pay is for board meeting and committee meeting attendance, plus other activities related to that service.

Board Chair (Outside Member)

Directs board meetings. This is typically an elected by other board members who are in turn elected positions where individuals serve the needs of shareholders.: Votes on various matters. Manages various committees. Likely unpaid for service if an inside member who also serves as a member of management. As an outside board member, pay is for board meeting and committee meeting attendance, plus other activities related to that service.

Board Vice Chair (Outside Member)

Assists the Chairman of the Board of Directors. This is typically an elected position where individual serves the needs of shareholders.: May direct board meetings. Votes on various matters. Manages various committees. Likely unpaid for service if an inside member who also serves as a member of management. As an outside board member, pay is for board meeting and committee meeting attendance, plus other activities related to that service.

Medicare Member Services Director

Plans and directs Medicare operations including claims, information systems, purchasing, and facilities to ensure processing of the health plan's Medicare claims. Ensures that all operations meet the plan's objectives and requirements relative to Medicare members and providers. Directs the implementation and ongoing maintenance of claims handling systems, policies, and procedures. Typically requires a college degree and five or more years of Medicare claims management experience.: Monitors departmental operations to ensure compliance with regulatory agencies as well as contractual obligations. Performs regular data analysis of claims payment reports to identify variances so that areas of focus may be identified and resources may be appropriately deployed. Prepares and manages the departmental budget and manages expenses. Hires, develops, and motivates a qualified claims processing staff. Provides support on complex claims issues.

Vice Chair Board (Outside Member)

Medicare Member Services Manager

Manages Medicare Service Representatives within the Medicare Membership function in a health plan. Monitors departmental statistics, reports results and develops action plans that address deficits. This position typically requires five years of health plan experience in a customer service call center.: Manages Medicare Service Representatives within the Medicare Membership function in a health plan. Implements policies and procedures within the Medicare Membership department to ensure provision of accurate explanation of benefits and response to Medicare members’ questions and complaints. Plans, implements and continuously evaluates the Medicare member service program to enhance the effective use of services and to improve customer satisfaction. Instructs departmental staff on proper member service procedures and monitors service levels. Researches and evaluates complaint reports to detect patterns, formulate solutions and report needed actions to appropriate individuals, departments or committees. Works with Medicare members on complex issues to offer mutually acceptable alternatives to problems and complaints. Responsible for hiring, developing and managing a qualified staff concerned with providing member service to Medicare members of the health plan. Assists in the preparation and management of the departmental budget. Monitors departmental statistics, reports results and develops action plans that address deficits. This position typically requires five years of health plan experience in a customer service call center.

Member Services Supervisor

Supervises employees responsible for responding to member inquiries. Provides customer service training and monitors employee response to inquiries to assure quality. Handles complex inquiries that cannot be handled by Member Services Representatives. Organizes and distributes the department workload.: Supervises employees responsible for responding to member inquiries. Provides customer service training and monitors employee response to inquiries to assure quality. Handles complex inquiries that cannot be handled by Member Services Representatives. Organizes and distributes the department workload. Monitors incoming phone calls to ensure that members are treated with respect and that performance standards are met or exceeded. Answers incoming calls when call volume necessitates. Tracks call volumes and amount of time spent offline to measure departmental effectiveness. Troubleshoots problems and works with members on complex issues to offer mutually acceptable alternatives to problems and complaints. Provides training to staff as needed. Communicates with other departments to ensure resolution of member problems. This position typically requires a college degree with three years of health plan experience in a customer service call center. May order supplies and maintain supply inventory. May coordinate and supervise temporary workers used within the department.

Member Records Administrator

Categorizes and sorts member records for a membership association or organization. Ensures that records are complete and accurate.: Identifies, organizes, and integrates files for storage or destruction. Coordinates the access, security, and circulation of records according o approved policy and procedure. Organizes, converts, and integrates files for storage. Consults with users on automated records management applications and recommends solutions. Ensures that all information practices meet State regulatory requirements and company standards. May process new memberships and renewals.

Clergy Member Head

Supervises and coordinates activities of pastoral services involving religious worship and other spiritual functions associated with beliefs and practices of religious faith or denomination as authorized, and provides spiritual and moral guidance. Interprets doctrine of religion. Instructs people who seek conversion to faith. Counsels those in spiritual need and comforts bereaved. Oversees religious education programs. To carry out the responsibilities at this level typically requires a four-year degree.: May write articles for publication and engage in interfaith, community, civic, educational, and recreational activities sponsored by or related to interest of denomination. May prepare and deliver sermons and other talks. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action.

Member Services Manager

Manages a department concerned with responding to members' written, telephone and/or personal inquiries. Plans, implements and continuously evaluates the customer service program to enhance the effective use of services and to improve customer satisfaction. Instructs departmental staff on proper member service procedures and monitors service levels. Researches and evaluates complaint reports to detect patterns, formulates solutions and reports needed actions to appropriate individuals, departments or committees.: Manages a department concerned with responding to members' written, telephone and/or personal inquiries. Plans, implements and continuously evaluates the customer service program to enhance the effective use of services and to improve customer satisfaction. Instructs departmental staff on proper member service procedures and monitors service levels. Researches and evaluates complaint reports to detect patterns, formulates solutions and reports needed actions to appropriate individuals, departments or committees. Works with members on complex issues to offer mutually acceptable alternatives to problems and complaints. Responsible for hiring, developing and managing a qualified staff concerned with providing customer service to members of the health plan. Prepares and manages the departmental budget. Monitors departmental statistics, reports results and develops action plans that address deficits. Participates on various committees to formulate actions to proactively address member and provider needs. Prepares and presents management reports that show departmental activities as well as specific problems identified and solutions. Develops and implements policies and procedures related to customer service. This position typically requires a Bachelor’s degree with five years of health plan experience in a customer service call center.

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