JOB DESCRIPTION
TITLE: Medical Discount Program Director
REPORTS TO: Senior Director of Operations
SUPERVISES: Medical Discount Program Manager
BASED AT: Access to Healthcare Network office
Status: Exempt
JOB PURPOSE: The Member Services Director serves as the focal point for all member
and provider relations and provides leadership for the development of operational
systems and procedures that ensure AHN functions at an optimum level for both our
members and our providers.
KEY RESPONSIBILITIES AND ACCOUNTABILITIES:
MDP PROGRAM MANAGEMENT (PROGRAM MEMBERS AND PROVIDER NETWORK)
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Establish strong relationships with prospective providers and build upon
existing relationships
Demonstrate and role model the importance of treating Medical Discount
Program members with dignity, empathy and compassion
Directly responsible for maintaining the stability of the MDP provider
network; which includes provider recruitment, in-services and re-in-services
Assign and maintain the Provider Eligibility Portal; create a new account for
any provider requesting portal access
Ensure the procedure and prescription online pricing tool is updated and
accurate
Develop and implement coordinated strategies to ensure:
o Effective communication with AHN providers and members in regards
to their program responsibilities, protocols and guidelines
o Prompt and accurate payment from members to providers at the time
services are rendered
o Provider issues are handled quickly and effectively
o All Care Coordinators have up to date and accurate working
knowledge of the AHN fees, network of providers, AHN programs,
systems and processes; including, but not limited to Salesforce
Develop and maintain member materials
Coordinate delivery of materials/forms/brochures for providers
Develop and maintain working relationships with AHN partner organizations
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Develop and implement a method of reporting on outcome and quality
measures in the Member Services Department
Point of contact between MDP and all other AHN departments
Assist in the management of complex cases; including management of
provider referrals, generating price quotes, researching/locating available
resources for member
Field inquiry calls from interested parties, including potential members and
employers; explain program requirements, make timely disposition of calls
and take appropriate actions on inquiry calls and referrals
Develop new programs as needed
MDP STAFF MANAGEMENT
 MDP Director has direct oversight of and responsibility for the MDP Manager
 Develop and implement initial and continued training for Manager and Care
Coordinators
 Monitor Attendance Calendar and submit bi-weekly timecard(s)
 Assist in the hiring and training of Member Services employees (Care
Coordinators, Managers, Supervisors, etc.)
 Assist in the supervision of Care Coordinator daily activities
 Conduct (monthly or quarterly) staff 1:1meetings
 Manager annual review
OTHER REQUIREMENTS:
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Embrace and role model AHN values and culture
Use data and trend analysis for implementing process improvement
Demonstrated success in membership services or customer relations
Ability to evaluate and improve member needs
Knowledge of health care delivery and/or health care insurance
Demonstrated experience in planning and execution of tasks
Excellent organization skills and ability to manage complex processes
Ability to describe and communicate complex concepts
Ability to respond to member inquiries or complaints
Gain clear and working knowledge of Access to Healthcare Network services
available to our members
Gain clear and working knowledge of the provider referral and payment
process
Gain advanced knowledge of the Salesforce system used in tracking
demographics and service data, case management and member referrals
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Gain a clear and working knowledge of the Nevada Check-Up, Medicare and
Medicaid enrollment criteria and process
Gain clear and working knowledge of social services available throughout
our community
Travel throughout the state as needed
Abide by all HIPAA requirements
Gain working knowledge of the Shoretel phone system
Gain working knowledge of Brightmetrics software
Ability to be both compassionate and professional while serving our member
population and staff
Must attend staff meetings and meet with Senior Director of Operations
and/or COO on a consistent and regular basis
Ability to adapt to changing work environment and duties
Other duties as assigned
QUALIFICATIONS
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Bilingual and diverse cultural experience preferred
Bachelor’s degree in social work, public health administration, sociology,
psychology or related field preferred. Or a combination of education and
experience.
Three years management experience of multiple staff and a division or
department
Three years’ experience managing complex systems down, laterally and up
Two years working in health care related field or two years working with
special needs populations combined with knowledge and understanding of
case management.
Minimum two year computer experience including Microsoft operating
systems, word processing, spreadsheets, data base input and report
Be able to stand between 3 – 6 hours per day
Be able to withstand hand/wrist deviation and repetition
Be able to lift, carry up to 20 pounds with a fair consistency
Be able to sit at a computer for up to 6 hours at a time
Excellent verbal communication and customer service skills
Must have valid Driver’s license
Required to pass a background check through the State of Nevada
WORK ENVIRONMENT
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The noise level in the work environment is usually moderate and the
employee usually works in a climate-controlled office environment
*The statements herein are intended to describe the general nature and level of
the position, but are not necessarily a complete list of responsibilities, duties and
skills required of employee(s) so classified. As such, responsibilities, duties, and
required skills may be changed, expanded, reduced, or deleted to meet the
business needs of Access to Healthcare Network. Furthermore, they do not
establish a contract or implied contract for employment.
As an equal opportunity employer, we are committed to identifying and
developing the skills and leadership of people from diverse backgrounds. We
encourage all qualified candidates to apply.
Reviewed & accepted by: ______________________________________________ (Signature)
Date: ___________________________
______________________________________________ (Print)
TR & LO 03.01.2016
SR 3.11.2016