Member Support Specialist Team Lead - DSNP

PacificSource Health Plans - Portland, OR

Full-time - Mid Level

Portland, OR

Insurance Carriers and Related Activities

About the position

The Member Support Specialist Team Lead at PacificSource Health Plans is responsible for supervising and guiding the Case Management Member Support Services team. This role involves hiring, training, coaching, and evaluating team members to ensure high-quality service delivery and adherence to company policies. The Team Lead will also assist in resolving member and provider issues, develop departmental metrics, and foster effective communication networks to support members in navigating healthcare and social systems.

Responsibilities

• Supervise and provide guidance to Case Management Member Support Services team members.
• Responsible for hiring, training, coaching, counseling, and evaluating team member performance.
• Assist in resolution of provider/community partner and member issues referred to Case Management Department services.
• Evaluate performance of team members and analyze results of performance reports to determine training needs.
• Assist team in developing and implementing goals and plans tailored to assist members in navigating healthcare and social systems.
• Create, evaluate, and track departmental metrics to measure performance.
• Oversee team in identifying and creating exceptional customer communication networks regarding community resources.
• Utilize motivational interviewing techniques to support customers in utilizing healthcare resources.
• Serve as liaison between members, providers/agencies, and community partners.
• Identify members for coordination and case management services through various methods.
• Participate in the development and maintenance of the Case Management Department Manual and policies.
• Prepare materials and presentations for meetings and educate staff and community partners.

Requirements

• A minimum of four years of experience in community services or healthcare agencies focused on coordination services required.
• Supervisory experience preferred.
• High school diploma or equivalent required.
• Personal Health Navigator (PHN) certification required within two years of hire or promotion.
• Excellent verbal and written communication skills.
• Proficient in Microsoft Office, including Word, Excel, and PowerPoint.
• Good working knowledge of community resources and healthcare systems.
• Basic math skills including percentages, ratios, and spreadsheet skills.

Nice-to-haves

• Experience in healthcare management software.
• Knowledge of HIPAA standards and confidentiality regulations.

Benefits

• Health insurance
• 401k retirement plan
• Paid time off
• Professional development opportunities
• Employee assistance programs