Gretchen Post Email & Phone Number

Salem Oregon

The Claims Administration Manager is primarily responsible for overall management and dailyoperations of the contracted claims administration and processing functions. This includes processand claims inventory management; customer service for health plans and providers; and teammanagement.Process ManagementOversee the day to day operations involving assigned accounts.Claims ProcessingMaintain orderly and systematic claims processing functions. Understand each vendor's individualneeds, contracts, and problems. Finding and fixing errors before they become problems.Customer ServiceMaintain excellent relationships with all internal and external customers and work to resolve anyrequests or issues presented.Department ManagementOversee the day-to-day operations for the department.Team ManagementManages team to optimize productivity, job satisfaction, and skills developmentPolicies & ProceduresAssure Department Policies and Procedures are complete, accurate, and up-to-date and that they are followed, understood, and taken seriously.

This position is responsible for coordinating and directing all aspects of member related services for the Health Systems Division with the Oregon Health Authority. This requires direct control over the entire caseload of over 1 million Oregonians who currently receive Oregon Health Plan benefits; direct operations for processing applications to determine program eligibility, call center support and Coordinate Care enrollment and re-determinations.

Salem, Oregon

Assistant Manager for the Coordinated Care Support Unit of MAP, Medical Assistance Programs for the State of Oregon. Direct and monitor the work of professional and technical staff involved in design, development, improvement and operation of the Coordinated Care Support for Oregon Medicaid. This includes overseeing the enrollment and dis-enrollment functions, member material review and approval, technical and operational support for Coordinated Care Organizations, dental, mental health and primary care organizations. Oversees process and operations creation, interpretation and monitors administrative rules, policies, contract and programs affecting Coordinated Care in health, dental and chemical dependency care for MAP clients. T

Salem, Oregon

Responsible for the start-up and ongoing operations of the Cover Oregon Service Center facility. Directly responsible for the successful execution of call center implementation, quality controls, employee development, processes, and Service Center solutions. Provide strategic, creative and logistical leadership and participate in the development, implementation and management of the service center program. Motivate Service Center staff to achieve high performance, oversee the design and delivery of all training programs, monitoring of calls for quality assurance, recruiting and hiring of new personnel and handle escalated concerns that fall outside the purview of the Service Center Supervisor team. Maintain and create relationships with External and Internal Cover Oregon stakeholders.

Held a variety of positions. Member Account Services Manager for the Office of Private Health Partnerships- managed all enrollment and billing activities for the Family Health Insurance Assistance Program. Provided subsidies to families based on eligibility requirements and income limitations based on federal poverty levels. Worked with a variety of stakeholders, various State Agencies, Commercial Insurance Carriers, Insurance Division and licensed insurance Agents. Accounting and IT Manager- Office of Private Health Partnerships - managed the day to day operations of Accounting and IT during the transition to Shared Services with the Oregon Health Authority.Project Management- Assisted in managing the implementation of Coordinated Care Organizations for the Oregon Health Authority.

Salem, Oregon

Started as a Customer Service Representative within the Pharmacy Customer Service Team. Worked up to the Supervisor position. Supervised the day to day work of 16-19 call center staff.

Education record

Education record