Job description
Overview:
Qualifications:
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Responsibilities:
The MAP (Medicaid Advantage Plan) Specialist is responsible for making telephone calls to current HomeFirst members with the intent to educate them on Elderplan’s Medicaid Advantage Plus Plan benefits. Tasks include verifying plan eligibility, in-network status of the member’s current providers, and documenting and capturing activities accurately to ensure the integrity of the process. The position requires excellent communication and organizational skills to facilitate superior coordination between members, Sales Operations, Business Enrollment, Care Management, Assessment Nurses, and the providers. The Specialist will ensure adherence to Medicare and Medicaid guidelines and internal policies.
Qualifications:
- High school diploma required, Associate or Bachelor’s Degree preferred.
- Prior experience in coordinating services in the community or health care settings required.
- Prior managed care experience preferred.
- Microsoft Word, Excel, PowerPoint, capacity to learn other programs as assigned.
- Excellent customer service skills.
- Excellent written and oral communication skills.
- Good analytical abilities.
- Ability to be empathetic and understanding.
- Ability to handle confidential aspects of the position.
- Ability to work closely with different professionals as part of an interdisciplinary health care team.
- Ability to set priorities.
- Ability to work independently while recognizing issues having departmental or organizational impact.
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