Common use of Member Services Manager Clause in Contracts

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 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, POWER Account services, GTW 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 7.

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 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, POWER Account services, GTW 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 7.

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 departments to address and resolve member grievances and appeals. The Member Services Manager shall oversee the interface with the Enrollment Broker EXHIBIT 1.A SCOPE OF WORK 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, POWER Account services, GTW 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 74.0.

Member Services Manager. The Contractor shall must employ a Member Services Manager who is dedicated full-time to member services for the Contractor’s Healthy Indiana Plan product linePathWays 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 EXHIBIT 1 SCOPE OF WORK – INDIANA PATHWAYS FOR AGING website, member outreach programs, development, approval approval, and distribution of member materials and employer outreach for HIP membersmaterials. The Member Services Manager manages the member grievances and appeals process, process and works closely with other managers (especially, the Quality Improvement Manager, Utilization Manager 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, and member eligibility and newborn enrollment activities eligibility. The Member Services Manager shall provide an orientation and on-going ongoing 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, POWER Account services, GTW 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 compliant with the terms of the Contract. For more information regarding the member services program requirements, see Section 7.Section

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 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, POWER Account services, GTW servicesservices , 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 EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN member services program requirements, see Section 74.0.

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 Medicaid product linelines, 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 membersmaterials. 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 activities. The Member Services Manager shall provide an orientation and on-on- going training for member services helpline representatives, at a minimum, to support EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE 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, POWER Account services, GTW 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 74.0.

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 Medicaid product linelines, 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 membersmaterials. 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 activities. The Member Services Manager shall provide an orientation and on-on- going training for member services helpline representatives, at a minimum, to support EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE 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, POWER Account services, GTW 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 wit h the terms of the Contract. For more information regarding the member services program requirements, see Section 74.0.

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 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, POWER Account services, GTW servicesservices , 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 EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN in compliance with the terms of the Contract. For more information regarding the member services program requirements, see Section 74.0.

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 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, EXHIBIT 1 SCOPE OF WORK – HEALTHY INDIANA PLAN benefit plans and limitations, health screenings, emergency services, PMP assignment and changes, specialty provider referrals, self-referral services, preventive and enhanced services, POWER Account services, GTW servicesservices , 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 74.0.

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 departments to address and resolve member grievances and appeals. The Member Services Manager shall oversee the interface with the Enrollment Broker EXHIBIT 1.A SCOPE OF EXHIBIT 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, POWER Account services, GTW 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 74.0.