member services representative

manager

case manager

analyst

claims representative

Neighborhood Health Plan of Rhode Island

A typical day in this role involved preparing sendback letters for paper claims containing errors, sorting incoming mail, and performing data entry for claims eligible for processing. These responsibilities provided valuable exposure to medical claims workflows and offered insight into the organization’s approach to duplicate claim handling. The position presents solid opportunities for developing foundational knowledge in claims processing.
However, the management experience significantly detracts from the overall role. Feedback practices are inconsistent and often ineffective. Employees may receive little to no constructive input, or exclusively neutral/positive feedback, followed by termination without prior warning or documented performance concerns. This lack of transparency makes it difficult to understand expectations or improve performance. Attempts to proactively seek clarification or feedback are frequently unsuccessful.
Training and supervision structures also present challenges. While initial onboarding relies heavily on peer-led instruction, employees are later directed to route all questions through management, creating confusion and communication gaps. Additionally, multiple teams report to a single supervisor, and interim leadership has reportedly been in place for an extended period without clear resolution. This can result in situations where supervisors lack sufficient familiarity with team-specific responsibilities, leading to misunderstandings regarding performance metrics and expectations.
There is also inconsistency in how performance is measured and communicated. Employees are advised that metrics will not be emphasized during training, yet are later expected to independently track and manage their performance without clear guidance. This creates an environment where expectations can feel unclear or shifting.
From a cultural standpoint, the workplace may feel more aligned with certain demographics, and some employees may find it less inclusive depending on their background or preferences. While work-life balance is emphasized during onboarding, in practice there may be informal expectations that extend beyond scheduled hours. Employees may also be asked to support additional tasks across teams when their primary workload is complete, which can broaden experience but may also create ambiguity around role boundaries.
The most challenging aspect of the position is navigating unclear expectations and limited communication from management, despite frequent but largely superficial check-ins. In contrast, the day-to-day responsibilities are engaging, and colleagues at a similar level are generally supportive and pleasant to work with.

Pros:
The benefits are really good with the exception of when you get hired you need to wait 30 days to receive health benefits. The people are great - very knowledgeable and overall a very collaborative environment.  It’s a small organization so u can get to know people very easily.  
Cons 
Director of Operations does not demonstrate or practice the values that the organization prides themselves on.  Great example of a bad leader grooming more bad leaders like herself.  Communication is always 1 way and no respect is given to contractors or employees.   Condescending and undermining behavior is the norm.  Nothing is done by HR or any other more senior leadership to address the trail of talented people who leave the organization due to this toxic and negative work environment within operations.  It is a known issue throughout the organization that does not  get addressed which is why people leave.
Lack of work from home flexibility for ALL employees/micro managerial culture within business operations department especially/culture of distrust/lack of respect for people’s contributions and people’s time/people in key leadership positions regularly speak down to, yell and verbally abuse both contractors and employees. Lack of clear roles and responsibilities.    

Advice to Management 
Remove/demote those leaders who prevent talented people from staying.  
Conduct regular 360 degree (skip level) feedback on leaders who manage resources. 
Hold leaders accountable for not following the organization’s principles and values when it comes to employees.

Beware: The Most Exhausting “Training” Imaginable – Save Yourself the Headache

If you’re considering working as a Senior Claims Adjuster here, I’d urge you to think twice. My “training” was two weeks of watching a mouse cursor move around a screen for eight hours a day, expected to memorize every click. There was almost no real hands-on learning, just hours of screen-watching.

Live instruction was minimal, and the main interaction with the trainer was to ensure we were always visible on webcam—smiling, looking engaged, and sitting at our desks—regardless of whether any meaningful work was actually happening. If I took even a short break or helped a coworker, it felt like it was frowned upon. I even got in trouble for not turning my camera back on fast enough after a scheduled break.

Assignments were finished early, but the work was never collected or reviewed. Trying to use the extra time productively wasn’t appreciated. Instead, it felt like the most important thing was to always appear busy, regardless of what was actually being accomplished.

Eventually, I was let go without warning, feedback, or any real conversation about my experience. Despite coming in with excellent recommendations and a strong background, no one was interested in what I could bring to the team.

In short, the company’s culture seems to revolve around constant monitoring and little trust. If you’re looking for a workplace that values initiative, trust, and professional respect, this is probably not the right fit.

Rotten experience! First off never believe a recruiter ever! Second the 2 supervisors are immature and not able to control there employees. I worked in provider services. Hard job! Reps allowed to YELL at providers calling in! So much gossiping and backstabbing among reps to each other. No team atmosphere. Providers hate us and Neighborhood. Try dealing with that on every call. They want to talk to supervisor. Supervisors refuse cuz they don't know whats going on neither! What a hot mess of a job. We were paid FIFTY CENTS more an hour then member service reps! What a slap in the face. So glad they put me out of my misery and let me go. Training is a JOKE! They read to you off handouts for a few weeks. Who can't do that? You do that for a few weeks then 'nest' with a coworker who has been there just a short time more then you who is NOT interested in your succeeding. They actually think there on vacation and pay no attention to you, so your thrown to the wolfs when you get on the phone. Mess!! Run!!! Not worth the low pay no matter what these lying recruiters tell you! Sometimes it takes a year to get hired, unless your perfect and one of there favorites. You get SEVEN minutes to go to the bathroom every day, 2 ten minute breaks, and 30 for lunch. Awful!

The teams in member services are over stressed, worked, low compensated, and no advancement for seasoned reps. The management team from senior manager to floor supervisor don't advocate to higher management on employees behalf. The company  is trying to run a non profit insurance company as those of their competitors such as BCBS, UHC, TUFTS..yet they dont have the systems, employee capacity, and compensation to provide the top notch service they so market to the community they serve. This company underwent internal restructuring and yet member services was not given the emphasis that it needs with better systems, better compensation, work-life balance to their employees, and further advancements in the company. This company like to over work the temp employees which later translates to a high turn over rate in member services specifically. Managers also lack tact and communication within the dept of customer service is terrible if not horrible, all the perks this company gives to their other depts is non existent to member services, the most important dept in the whole company, which should be rewarded and recognized as so.

The expectations of managers constantly fluctuate based on their moods. They treat you like a robot instead of a person. If they make a mistake, they blame their employees for it. Constant finger pointing, horrible communication, and lack of accountability for other teams. My team became a dumping ground for what others teams did not want to do. Favoritism is blatant and obvious. The favorites get raises, promotions, and recognition. Friends of managers are elevated to high positions. Managers show up into the office late or work from home for extended periods of time, but do not allow employees under them the same luxury. 
Hard work is rewarded with more hard work. Grossly underpaid for the amount of work good employees put into the company. 
Upper management needs to be restructured from the top down. There’s a very clear reason why good people are leaving in droves. Focus needs to be more on consistency with policies, expectations, and work life balance for employees. This company will treat you sweet until you make one small mistake. Your opinion is asked for, but then you are shamed and yelled at for contributing your opinion. 

The best part about this job are the benefits and flexible Fridays where you work from home. These days are supposed to be meetings free, but there are always unnecessary meetings scheduled. 

Work is 37.5 hours week. Some positions in office some hybrid, some community some fully remote. Flexible at times unless there are deadlines. Some positions much more stressful, high paced with unrealistic expectations.
 Other positions not so much. IT personal love thier jobs. Benefits are pretty amazing! You do usually (most pay grades) get yearly, taxed highly (not NHPs fault) bonus. Yearly raises between 2-3% if meeting expectations. In my opinion not high enough with the economy & the savings we are helping the company with.  Love working in community with our members.
 We DO make a difference. NHP does care about their members. 
DEI is fantastic many lunch and learns and learning opportunities.
I have learned an abundance on community resources, CMS; Medicare/Medicaid, auditing and colaborating.
Management is a tough one, I guess its a case by base basis. There is much favoritism within the most busy departments. If you are okay with a decent base salary and bonuses ect with not much option to move up you'll be fine. They do offer tuition, paid upfront not reimbursed which is great. 

This place is crumbling apart piece by piece.  They have uneducated supervisors and managers.  They don't invest in their employees.  Employers need to realize that you need to invest, encourage and empower your staff to become members of professional organizations, acquire specialty certifications, attend professional conferences. They need to provider leadership classes and certifications to all employees.  Managers and Supervisors need to mentor their staff to take on leadership positions, but that doesn't happen, so instead you get supervisors and managers who haven't been mentored and have no experience, skills or education to be managers or supervisors.  Their whole leadership, from the directors on down to the supervisors are incompetent. There is a HUGE turnover of staff and unfortunately, the stupid managers and supervisors stay.  Leadership is too stupid to realize that the reason staff are leaving are because of them.

On a standard day I would arrive and work on drug/formulary review material which was required of me on a weekly basis. I was also assigned various drug information questions which were delivered to me daily. Twice a week I would travel to a local community health clinic with another pharmacist to meet with patients and review their current medications. Other tasks that I may have been assigned on a typical day revolved around becoming familiar with the managed care aspect of pharmacy (i.e. prior authorizations, formulary decisions, sending out informational material to providers).

There is a high turnover in staff, especially in case management, and for a good reason.  Don't even bother applying, because you will be disappointed in a couple of months and want to quit once you learn about the environment and work culture.  Very poor management.  No respect for their employees.  Everything they say about themselves is totally the opposite.  They say that if you're sick, not to work, but yet reprimand you if you call in sick.  They say they don't discriminate against people with disabilities, but there have been people who have been fired for calling out sick due to a disability.  They say they support Veteran's, yet have no respect for their experience or what they might have endured. 

Top Job Titles	Average Salary
Member services representative 3 salaries reported	$20.72 per hour
Manager 3 salaries reported	$116,000 per year
Case manager 3 salaries reported	$72,333 per year
Analyst 3 salaries reported	$67,667 per year
Claims representative 2 salaries reported	$60,000 per year

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