Job ID: J117063
Company: Gateway Health Plan
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Feb 22, 2018
This job is the executive owner driving all elements of the member experience. The role is responsible for leadership in every phase of the member’s nonclinical experience, from the initial “Gateway to Care” welcome call to the successful resolution of appeals and grievances.
The VP, Member Experience devises and delivers the service delivery strategy as well as owns operational responsibility for all areas touching the non-clinical member experience including but not limited to:
Additionally, In support of Gateway’s future expansion, the VP Member Experience and the ME Team will work to promote member-facing initiatives that ensure Gateway’s competitiveness in new markets. Utilizing data from gDNA and other behavioral resources, the ME area will construct engagement initiatives that support and promote Gateway’s quality and care management activities. The ME team is comprised of specialists in member experience and engagement who work collaboratively with the quality and care management areas to develop programs driven by behavioral science and economic principles which will engage members in their care, motivate them to adopt behaviors which will improve their health outcomes, and construct member experiences which support them in these initiatives.
The team is also responsible for devising technology strategies which consistently engage members utilizing emerging technologies, lessening dependence on employee resources and increasing measurable and financially efficient results.
Provide oversight for operations and strategic activities related to service delivery functions including Customer Service Center (inbound and outbound call center activities). Deliver achievement of contractually required SLAs and KPIs while also ensuring the operations support the strategic goals of the member experience including supporting care management, member retention and quality goals.
Oversight for Appeals and Grievances Unit ensuring compliance with regulatory requirements for all A&G operations.
Operational leader for Customer 360 initiative in support of Gateway operational focus areas: implementation of member profile, member portal, interactive voice response (IVR) system, electronic outreach and other emerging technologies impacting the member experience in partnership with IT and the Data Analytics Warehouse.
Oversees Process Readiness and Audit Readiness functions and ensures implementation and adherence to government regulations and development and implementation of corrective action plans, policy and procures and process improvements.
Act as executive advocate ensuring positive member experiences while simultaneously providing feedback on issues impacting member satisfaction as determined through direct contact in focus groups, service center calls, and portal contacts.
Lead strategy and initiative development and operational implementation of member experience and engagement initiatives which support Gateway’s objectives and delivers on the promise of an exceptional member experience. Executive responsible for the Member Experience (ME) Team comprised of member experience and behavioral science specialists focused on constructing a member experience which drives the member to better health outcomes through engagement.
Lead the cultural transformation of member-centered service which builds on the member-centric clinical efforts already underway.
SCOPE OF RESPONSIBILITY
Does this position supervise others?
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
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