Sanjiv Raj

AVP, Customer Engagement at Health Partners Plans
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us****@****om
(386) 825-5501
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5.0

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Steven Shin

Sanjiv is a highly motivated, insightful innovator. He independently seeks out new challenges and has the aptitude and tenacity to address and resolve complex issues. Furthermore, he holds the experience and wisdom to weigh "high level" business needs with any individual situation, making him an extremely valuable asset to any team.

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Credentials

  • Critical Thinking: Tools for Effective Action
    Dale Carnegie Training
  • Leading Strategic Growth
    Columbia Business School

Experience

  • Health Partners Plans
    • United States
    • Hospitals and Health Care
    • 300 - 400 Employee
    • AVP, Customer Engagement
      • Jun 2022 - Present

  • AmeriHealth Caritas
    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Director, Medicare Customer Service
      • Jan 2017 - Jun 2022

      Managing the Medicare customer and provider Contact Service Centers of Excellence across multiple sites. Development, implementation and ongoing management of the Company’s Medicare Advantage customer service processes. Responsible for customer service from an operational and compliance perspective, including adherence to state and federal laws and regulations; oversight of delegated entities to ensure compliance to CMS customer service operations requirements, and performance related to CMS audits and ratings. Ensure operational excellence and best in class beneficiary service. Collaborate and work in a matrix environment with the clinical and medical management teams, UM, Quality, Appeals and Grievances, Finance and Compliance to effectively manage the operations and delivery of a 5 Star customer experience.

    • Manager Northern Region Rapid Response and Outreach Team
      • Jun 2014 - Jan 2017

      Managing multiple teams of Care Connectors in taking ownership of addressing the members care gaps in their health, identifying barriers to health care and delivering the right tools, services and education necessary to keep them healthy and reducing costs. Executed multiple outreach campaigns to proactively help members manage their health and prevent re-admissions and unnecessary emergency room visits. Training the team to compassionately deliver a great customer experience while achieving all HEDIS and NCQA goals.

  • AAA South Jersey
    • United States
    • Motor Vehicle Manufacturing
    • 1 - 100 Employee
    • Manager Member Services
      • Mar 2011 - Jun 2014

      Management and operations of the 24/7 contact center. Experience in delivering a totally satisfied customer experience, strategic planning, sales and conflict resolution. Management and operations of the 24/7 contact center. Experience in delivering a totally satisfied customer experience, strategic planning, sales and conflict resolution.

  • ING DIRECT
    • Manager
      • Jan 2001 - Sep 2010

      Coach for the sales and customer service teams of the online brokerage services division. Expertise in retirement accounts. Registered Principal with Series 6, 63, 65, 7 and 24 licenses. Coach for the sales and customer service teams of the online brokerage services division. Expertise in retirement accounts. Registered Principal with Series 6, 63, 65, 7 and 24 licenses.

Education

  • University of Madras
    Ph.D, Biochemistry

Community

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