Providence St. Joseph Health Supervisor Health Plan Operations, Commercial *Remote* in Vancouver, Washington

April 1, 2024

Job Description

Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Supervisor Health Plan Operations, Commercial – Customer Service who will:
Lead a professional team of Customer Service Agents responsible for servicing Member and Provider telephone, chat and email inquiries
Possess a well-rounded and diverse level of product expertise for the Commercial (Full Risk) line of business
Demonstrate knowledge and expertise with supporting:
Quality Improvement initiatives
Resolution of claims and enrollment issues
Rapid identification of customer service production and resource issues related to resource and staffing deficiencies
Possess a strong working knowledge of applicable regulatory requirements regarding:
Accurate and timely claims processing
State, Federal and Regulatory inquiry response times
Member enrollment and materials distribution
Member status change transactions
Group and individual premium billing
Premium reconciliation
Delinquency and collection processes
Foster effective working relationships with vendors, consultants and other PHP staff in performing their duties
Perform a key leadership role in providing a supportive, team-based environment
We welcome 100% remote work for residents who reside in one of the following areas:
Oregon: Clackamas, Multnomah and Washington Counties
Washington: Clark County
Required qualifications for this position include:
Bachelor’s Degree in Business Management, Healthcare Administration, Accounting, or another related field of study and 4+ years of management/industry experience -OR- Associate Degree and 6+ years of related management / industry experience -OR- a minimum of a HS Diploma / GED Equivalency and 8+ years of related management / industry experience
Preferred qualifications for this position include:
1+ years of customer service background in managed care environment
1+ years of experience navigating Behavioral Health benefits and policies
Experience in project management methods
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line withi


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