Member Services Representative, Sr. jobs in Portsmouth, NH

Member Services Representative, Sr. addresses more complex health plan or HMO member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. Responsible for receiving, responding to, and directing member phone calls and written requests. Being a Member Services Representative, Sr. provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Additionally, Member Services Representative, Sr. requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Member Services Representative, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Member Services Representative, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Sr. Director Cancer Services
  • Wentworth-Douglass Hospital(WDH)
  • Dover, NH FULL_TIME
  • Description

    Wentworth-Douglass Hospital, a subsidiary of Massachusetts General Hospital, is renowned as one of the largest acute care hospitals in the Seacoast region of New Hampshire and Southern Maine. The Seacoast Cancer Center at Wentworth-Douglass Hospital provides the most comprehensive program of medical and radiation oncology in the Seacoast of NH and Southern Maine. Our services include diagnostic testing, chemotherapy services, radiotherapy services, clinical trials and a full complement of support services designed to meet the specials needs of our patients and families.

    The Sr. Director of Cancer Services is responsible for leading all cancer center services provided at our patient-centered facilities in Portsmouth and Dover NH. The Sr. Director, in collaboration with the cancer services leadership team, coordinates all aspects of program development, strategic initiatives and budgets. The Sr. Director assures compliance with Joint Commission and other regulatory bodies. The Sr. Director of Cancer Services reports to the President and Chief Operating Officer and works closely with other leaders of clinical departments within the hospital on quality and safety initiatives, operational efficiencies, and clinical program development. The Sr. Director of Cancer Services is responsible for translating the Hospital's Mission, Vision and Values into meaningful action and creating a high-quality product and patient experience balanced with a cost appropriate and timely framework.

    1. Operational Functions

      1. In collaboration with physicians and the Chief Nursing Officer, oversees clinical and administrative functions of all cancer services.
      1. Oversee and provide leadership for the operational, financial, and strategic functions of the cancer services, fostering personal, multidisciplinary care.
      1. Collaborate with key stakeholders and leadership to ensure the awareness and promote the integration of the product line across departments, system, and within the community and region.
      1. Monitor and develop as necessary the organizational structure to ensure the profitability of all cancer services.
      1. Responsible for the daily operations and personnel as well as the financial and business planning, business and new program development, marketing and communications, and physician relations for all areas.
      1. Facilitate top line growth through relationship development and clinical services implementation.
      1. Develop appropriate structures and processes, aligned with product line's strategic plan, to ensure that operational, financial, and strategic goals are achieved.
      1. Formulate operational, business, and tactical plans for programmatic growth and service delivery.
      1. Utilize internal and external data sources to evaluate the efficiency of continuing, growing, and adding services; prepare and present necessary financial, statistical, and operational data for new programs, services, and processes.
      1. Collaborate effectively with physicians and nursing to oversee the development and implementation of clinical quality improvement efforts across all patient care settings.

    2. Actively involved in outside community activities which further advance the mission of the Hospital.

      1. Actively participate in community events and activities that further advance the mission of the Hospital and cancer service.
      1. Maintain awareness of market and regional data including incidence, morbidity, and mortality that reflects community needs for the cancer center.
      1. Maintain active membership and participate in relevant professional organizations related to cancer services.
    • Establish Common Vision and Goals: Strengthen staff understanding of organizational values and create an environment focused on achieving a common vision and goals.
      1. Identify and articulate a compelling vision for the unit/department and how that vision aligns with the organizational vision and shared values.
      1. Anticipate the impact of decisions on cross functional areas and engage with colleagues in the decision-making process to achieve organizational goals.
      1. Set leaders' and team goals to align with organizational goals.

    • Communicate Effectively:
      Effectively send and receive information to reach mutual understanding and meaning.
      1. Keep staff informed by clearly conveying information and ideas using understandable terms; explain rationale for decisions that impact them and the organization as a whole; cascade information from executive level to frontline.
      1. Demonstrate openness to and actively solicit new and creative ideas that will support organizational goals and future success.
      1. Actively listen, use appropriate body language, have empathy, and reflect what the other person is saying to ensure full understanding of content, context, and meaning of messages.

    • Act with Integrity:
      Adhere to moral and ethical principles; be honest; and act with consistency of values, principles, expectations, and outcomes.
      1. Follow through on commitments; do what we say we'll do even under difficult circumstances.
      1. Foster a climate of transparency, trust, and respect; be willing to speak up to the right person or group at the right time in support of organizational values and mission.
      1. Be resilient, demonstrated by optimism, clarity and flexibility even under stressful conditions; persevere through and bounce back from adversity; guide others through uncertain and challenging times.

    • Engage, Motivate & Develop People:
      Engage, recognize, reward, and motivate people to achieve excellence in their work. Develop the skills and potential of everyone to be able to meet the organization's future needs.
      1. Identify high potential individuals/possible successors and support their leadership development; establish goals, create plans, provide coaching, and resources to ensure a learning environment that fosters growth.
      1. Establish formal and informal mechanisms and forums for staff to share their ideas, actively solicit diverse opinions from others as a means for taking part in decision making and planning.
      1. Regularly thank people for their contributions, give positive feedback, and recognize, celebrate, and reward superior work.

    • Build Strong Teams:
      Create a positive team environment and promote effective teamwork within units and cross functionally. Hold people accountable for reaching agreed-upon outcomes.
      1. Create a team environment by providing role clarity, removing barriers and resistance, encouraging risk taking, playing to team members' strengths; and focusing on team results over individual results.
      1. Foster a culture of inclusion, openness, and trust that values cultural and generational differences and encourages collaboration; achieve genuine buy-in around important decisions, even when various members of the team initially disagree.
      1. Identify, select, and leverage team members based on diversity of style and experience and effective team skills.

    • Build and Manage Relationships:
      Build and maintain strong relationships based on trust and respect.
      1. Build collaborative relationships within and across teams, and departments; get things done by finding common ground without creating unnecessary adversarial relationships.
      1. Develop and maintain strategic relationships with affiliates, business partners, suppliers, payers, and the community.
      1. Maintain high visibility with direct reports, regularly conducting formal leadership walk rounds.

    • Service Excellence:
      Consistently meet and manage patient, family, internal and external customer expectations and uphold the highest service standards.
      1. Set and uphold high service standards to all customers and stakeholders, enrich the patient experience; establish appropriate service level agreements with key internal customers.
      1. Be dedicated to meeting and actively responding to needs and expectations from internal and external customers.
      1. Collect and analyze feedback data and use it to create action plans for improvements in services, experience, and products.

    • Foster Continuous Improvement:
      Foster the organization's ability to continuously improve, innovate, lead change, and achieve positive future outcomes.
      1. Identify, lead, and champion evidenced-based departmental continuous improvement and quality initiatives aligned with organizational priorities.
      1. Achieve quality and safety metrics; utilize data to achieve organizational goals.
      1. Lead and facilitate department and service area through transition and change by aligning, preparing, communicating, and guiding implementation of change initiatives.

    • Business Acumen:
      Execute the strategic initiatives and business operations necessary to achieve cost, quality, and service outcomes.
      1. Accurately analyze department needs and performance gaps, manage resources well, and increase efficiency.
      1. Create department business plans; make effective decisions; delegate authority and accountability appropriately.
      1. Meet financial targets and utilize data to manage operations and achieve organizational goals.

    • Compliance:
      Adheres to all organizational policies, procedures, regulatory and statutory rules, acting promptly on all potential discrepancies. Takes effective corrective action and /or informs appropriate individuals that a compliance breach has occurred.
      1. HIPAA: Protects the privacy of patient data written, electronically and verbally.
      1. Code of Organizational Ethics/Compliance: Understands and adheres to Duty to Comply, duty to Act in an Ethical Manner, Duty to Participate in Education & Training, Duty to Participate in Auditing and Monitoring, Duty to Participate in an Investigation and Obligation to Report.
      1. Non-Harassment: Maintains safe and secure work environment by refraining from physical violence, threats, intimidation and other types of harassment, verbal and non-verbal.
      1. Environment of Care/ Infection Control: Performs duties related to providing a safe environment and prevention and control of infection.
      1. Organizational Policies and Procedures: Is knowledgeable of, understands and adheres to all applicable departmental and organizational policies & procedures.
      1. Safety: Understands safety risk in area and develops plan to ensure employee and patient safety.
    Qualifications
    • Experience Minimum Required
      • At least five (5) years' experience in healthcare administration including nursing, operations, and business.

    • Education Minimum Required
      • Bachelor's degree in nursing
      • Master's degree or higher in a clinical, healthcare administration or related field.

    • Training Minimum Required
      • Progressive leadership training and skills.
    • Training Preferred/Desired
      • Clinical background

    • Special Skills Minimum Required
      • Positive team approach based on strong ethical values.
      • Highly motivated and independent with exceptional written and verbal communication skills.
      • Compassionate, well respected with excellent collegial relationship.
      • Committed to continued learning and personal development.
    • Special Skills Preferred/Desired
      • Knowledge of cancer service line with a focus on multidisciplinary care and exceptional outcomes.
      • Membership in related local, state and national organizations.

    • Licensure and/or Certifications Required
      • RN
    Primary Location: NH-Dover-WDH Main Hospital
    Work Locations:
    WDH Main Hospital
    789 Central Ave
    Dover 03820
    Job: Nursing-Management
    Organization: Wentworth-Douglass Hospital(WDH)
    Schedule: Full-time
    Standard Hours: 40
    Shift: Day Job
    Employee Status: Regular
    Recruiting Department: WDH Seacoast Cancer Center
    Job Posting: Apr 16, 2024


    Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.

     

  • 8 Days Ago

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Sr. Director Cancer Services
  • Wentworth-Douglass Hospital(WDH)
  • Dover, NH FULL_TIME
  • Description Wentworth-Douglass Hospital, a subsidiary of Massachusetts General Hospital, is renowned as one of the largest acute care hospitals in the Seacoast region of New Hampshire and Southern Mai...
  • 8 Days Ago

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Patient Services Representative
  • Aspen Dental
  • Seabrook, NH FULL_TIME
  • At Aspen Dental, we put You first, offering the security and job stability that comes with working with a world-class dental service organization (DSO). Our best-in-class training program, competitive...
  • 20 Days Ago

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Membership Services Representative
  • The Granite YMCA – Strafford County
  • Rochester, NH FULL_TIME
  • The YMCA of the Strafford County is a place for people to connect with others and improve their health and wellness. We are part of a vibrant community and strive to create a space that is welcoming t...
  • 21 Days Ago

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Patient Services Representative
  • York County Community Action Corp
  • Springvale, ME FULL_TIME
  • Nasson Health Care A Division of York County Community Action Corp.Nasson Health Care is a Federally Qualified Health Center with clinical sites in Springvale and Biddeford, Maine. We serve York Count...
  • 2 Days Ago

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Member Services Specialist
  • Safe Harbor Marinas
  • Castle, NH FULL_TIME
  • The Member Service Specialist is responsible for assisting members with their immediate needs. This may include, but not limited to, giving information on the facility, products and services, assistin...
  • 22 Days Ago

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0 Member Services Representative, Sr. jobs found in Portsmouth, NH area

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Member Service Representative, Andover, Part-Time
  • Digital Federal Credit Union
  • Andover, MA
  • ** Member Service Representative, Andover, Part-Time** **Job Category****:** Branch Services **Requisition Number****:**...
  • 4/26/2024 12:00:00 AM

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Member Service Representative, Andover, Full-Time
  • Digital Federal Credit Union
  • Andover, MA
  • ** Member Service Representative, Andover, Full-Time** **Job Category****:** Branch Services **Requisition Number****:**...
  • 4/26/2024 12:00:00 AM

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Customer Service Representative
  • Walmart
  • York, ME
  • **Job Title: Customer Service Representative (Walmart)** **Job Summary:** As a Customer Service Representative at Walmar...
  • 4/26/2024 12:00:00 AM

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Patient Services Rep - Per diem - Pulmonology
  • Wentworth-Douglass Hospital(WDH)
  • Dover, NH
  • Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, te...
  • 4/25/2024 12:00:00 AM

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Member Service Representative, Andover, Part Time
  • Digital Federal Credit Union
  • Andover, MA
  • ** Member Service Representative, Andover, Part Time** **Job Category****:** Branch Services **Requisition Number****:**...
  • 4/24/2024 12:00:00 AM

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Member Service Representative, Methuen, Part-Time, Onsite
  • DCU
  • Methuen, MA
  • Schedule Schedule: Wednesday 9:30 - 5:30, Thursday and Friday 11:30-7:30, and every Saturday 8:30-3:30 (27.50 hours) Wha...
  • 4/24/2024 12:00:00 AM

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Customer Service Representative
  • Walmart
  • Portsmouth, NH
  • **Job Title: Customer Service Representative (Walmart)** **Job Summary:** As a Customer Service Representative at Walmar...
  • 4/24/2024 12:00:00 AM

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Account Associate - State Farm Agent Team Member
  • Christopher Chapman - State Farm Agent
  • Dover, NH
  • Benefits: Bonus based on performance Opportunity for advancement Paid time off ROLE DESCRIPTION:Chris J Chapman State Fa...
  • 4/24/2024 12:00:00 AM

Portsmouth is a city in Rockingham County, New Hampshire, United States. As of the 2010 census it had a population of 21,233, and in 2017 the estimated population was 21,796. A historic seaport and popular summer tourist destination on the Piscataqua River bordering the state of Maine, Portsmouth was formerly the home of the Strategic Air Command's Pease Air Force Base, since converted to Portsmouth International Airport at Pease. According to the United States Census Bureau, the city has a total area of 16.8 square miles (43.6 km2), of which 15.6 square miles (40.5 km2) is land and 1.2 square...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Member Services Representative, Sr. jobs
$49,440 to $61,860
Portsmouth, New Hampshire area prices
were up 1.4% from a year ago

Member Services Representative, Sr. in Memphis, TN
The Member Service Representative (MSR) provides a high standard of financial service to existing and potential members, processing transactions and building relationships while promoting the products and services of the credit union.
December 24, 2019
Member Services Representative, Sr. in Manchester, NH
Customer Service Representatives interface with customers via inbound calls and/or the Internet for the purpose of resolving routine problems with products or services, specifically insurance plans.
February 13, 2020
Delivers best service possible to members when they have requests or queries, always looking for ways to improve our service to them.
January 15, 2020
Member Services Representative, Sr. in Killeen, TX
Provides such member services as opening new accounts, ordering checks, ATM maintenance, corrections, etc.
February 23, 2020