Participant Services Director at Keystone Peer Review Organization, Inc. in Springfield, Illinois

Job Description:

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.

Participant Services Director

Summary Description 

Oversee program activities to ensure NETSPAP Participants needs are met, including outreach and complaint resolution activities. Directly reasonable for Participant satisfaction metrics.

Accountabilities 

• Coordinates communications with Participants and other Participant services.


• Serves as a Participant’s advocate.


• Maintains sufficient Participant service staff to enable Participants to receive prompt resolution of their problems or inquiries.


• Oversees Participant complaint resolution activities.


• Provides accurate and timely reporting on Participant-related activities.


• Helps train all program staff on Participant related needs.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time. 

Supervisory Responsibility

• Outreach Specialists

Qualifications 

• Bachelor’s degree in a healthcare, human services or closely related field is preferred.

Experience

• Experience with Medicare/Medicaid policies is preferred.


• Experience with Participant advocacy activities strongly is preferred.

Mental and Physical Requirements               

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.   

EOE AA M/F/Vet/Disability

KEPRO is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

See job description