Member Services Manager Clause Samples
The 'Member Services Manager' clause defines the role and responsibilities of the individual or entity designated to oversee and coordinate services provided to members within an organization or association. Typically, this clause outlines duties such as managing member communications, addressing member inquiries, and ensuring the delivery of agreed-upon benefits or services. By clearly specifying the scope and authority of the Member Services Manager, the clause ensures accountability and streamlines member support, thereby enhancing the overall member experience and operational efficiency.
Member Services Manager. The Contractor shall employ a Member Services Manager who is dedicated full-time to member services for the Contractor’s Indiana Medicaid product lines, which shall be available via the member helpline and the member website, including through a member portal. The Member Services Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member website, member outreach programs, development, approval and distribution of member materials. The Member Services Manager manages the member grievances and appeals process, and works closely with other managers (especially, the Quality Manager, Utilization Manager and Medical Director) and departments to address and resolve member grievances and appeals. The Member Services Manager shall oversee the interface with the Enrollment Broker regarding such issues as member enrollment and disenrollment, member PMP assignments and changes, member eligibility and newborn enrollment activities. The Member Services Manager shall provide an orientation and on-going training for member services helpline representatives, at a minimum, to support accurately informing members of how the Contractor operates, availability of covered services, benefit plans and limitations, health screenings, emergency services, PMP assignment and changes, specialty provider referrals, self-referral services, preventive and enhanced services, well- child services and member grievances and appeals procedures. The Member Services Manager, in close coordination with other key staff, is responsible for ensuring that all of the Contractor’s member services operations are in compliance with the terms of the Contract. For more information regarding the member services program requirements, see Section 4.
Member Services Manager. A dedicated, full-time professional located in Mississippi to be responsible for Member Services functions.
Member Services Manager. The Contractor must employ a Member Services Manager. The Member Services Manager must, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member website, member outreach programs and development, approval and distribution of member materials. The Member Services Manager must oversee the interface with the Enrollment Broker regarding such issues as member eligibility, enrollment and disenrollment. The Member Services Manager must provide an orientation and on-going training for member services helpline representatives, at a minimum, to support accurately informing members of how the Contractor operates, availability of covered services, benefit limitations, health screenings, Emergency services, preventive and enhanced services, disease management, care management and complex case management services and member grievances and appeals procedures. The Member Services Manager, in close coordination with other key staff, is responsible for ensuring that all of the Contractor’s member services operations are in compliance with the terms of the Contract. For more information regarding the member services program requirements, see Section 4.0.
Member Services Manager. The Contractor shall employ a Member Services Manager who is dedicated full-time to member services for the Contractor’s Indiana Medicaid product lines, which shall be available via the member helpline and the member website, including through a member portal. The Member Services Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member website, member outreach programs, development, approval and distribution of member materials. The Member Services Manager manages the member grievances and appeals process, and works closely with other managers (especially, the Quality Manager, Utilization Manager and Medical Director) and departments to address and resolve member grievances and appeals. The Member Services Manager shall oversee the interface with the Enrollment Broker regarding such issues as member enrollment and disenrollment, member PMP assignments and changes, member eligibility and newborn enrollment activities. The Member Services Manager shall provide an orientation and on-going training for member services helpline representatives, at a minimum, to support accurately informing members of how the Contractor
Member Services Manager. The Contractor shall employ a Member Services Manager who is dedicated full-time to member services for the Contractor’s Indiana Medicaid product lines, which shall be available via the member helpline and the member website, including through a member portal. The Member Services Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member website, member outreach programs, development,
Member Services Manager. The Contractor shall employ a Member Services Manager who is dedicated full-time to member services for the Contractor’s Healthy Indiana Plan product line, which shall be available via the member helpline and the member website, including through a member portal. The Member Services Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member website, member outreach programs, development, approval and distribution of member materials and employer outreach for HIP members. The Member Services Manager manages the member grievances and appeals process, and works closely with other managers (especially, the Quality Improvement Manager, Utilization Manager and Medical Director) and
Member Services Manager. The Contractor must employ a Member Services Manager who is dedicated full-time to member services for the PathWays program, which shall be available via the member helpline and the member website, including through a member portal. The Member Services Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s member services, including, but not limited to, member helpline telephone performance, member e-mail communications, member education, the member
Member Services Manager. The Contractor shall employ a Member Services Manager who is dedicated full-time to member service
Member Services Manager. Individual shall be responsible for provision of all MCO Member Services activities. The manager shall have prior experience with Medicaid populations.
Member Services Manager. Shall provide oversight of the Member services functions of the Contract, including, but not limited to, Member helpline telephone performance, Member e-mail communications, Member education, the Member website, Member outreach programs, development, approval and distribution of Member materials. The Member Services Manager shall oversee the interface with the Agency or its Subcontractors regarding such issues as Member enrollment and Disenrollment.