Benefits Consultant II - Medicaid Eligibility Retention Specialist
Duration:
6 Months Position Type:
Contract Location:
Linthicum, MD
Job Description:
Healthcare Better Health of Maryland is looking for a Medicaid Eligibility Retention Specialist to work with and assist current Healthcare Better Health of Maryland (ABHMD) members to retain or renew their Medicaid eligibility and remain a member in the ABHMD Managed Care Organization (MCO) Plan, by preventing or rectifying the disenrollment of members due to loss of their Maryland Medicaid eligibility.
Key Responsibilities Understand, and assure compliance to and adherence with, the Medicaid enrollment regulations, and related Maryland HealthChoice program policies and procedures related to Maryland HealthChoice member eligibility redetermination and renewals polices.
Notify members, in accordance with ABHMD Policies & Procedures (which reflect Maryland Medicaid HealthChoice and Maryland COMAR regulations) of their loss of eligibility.
Ensure copies of notices and documentation are filed in Members electronic records.
Cultivate and maintain collaborative relationships - with primary care site partners, FQHC and community-based outreach/enrollment organizations - to engage their assistance in working with members to maintain their Maryland Medicaid eligibility and correct information.
Coordinate with Primary Care Sites when working with members on loss of Maryland Medicaid eligibility.
Thoroughly log all member related interactions into Salesforce for the purpose of accurate tracking and analysis.
Develop a process for effectively identifying members with issues and communicating resolution of the issue.
Complete a Weekly Status Report for Supervisor and ABHMD Managers.
Offer recommendations for improvements in ABHMD practices to enhance service delivery and member satisfaction.
Participate in ABHMD sponsored meetings and events.
Represent ABHMD in the community, when requested & provide other duties as assigned.
Job Requirements:
Minimum Qualifications and Professional Expertise:
Associate's Degree or equivalent experience.
Minimum Years' Experience Required 3-5 years BA/BS Degree preferred.
3
years of healthcare experience 2
years' experience specifically with Medicaid/Medicare program operations 1
years' experience with Medicaid policy, financing, program operations, business requirement development, or systems Experience working with Medicaid eligibility requirements, as well as enrollment, renewal and redetermination related regulations and process.
Experience in customer service, specifically working with low-income and culturally diverse populations or, Medicaid enrolled or eligible individuals in person and on the phone.
Experience working with healthcare systems/services and/or experience working with community organizations, social services and public resources.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
6 Months Position Type:
Contract Location:
Linthicum, MD
Job Description:
Healthcare Better Health of Maryland is looking for a Medicaid Eligibility Retention Specialist to work with and assist current Healthcare Better Health of Maryland (ABHMD) members to retain or renew their Medicaid eligibility and remain a member in the ABHMD Managed Care Organization (MCO) Plan, by preventing or rectifying the disenrollment of members due to loss of their Maryland Medicaid eligibility.
Key Responsibilities Understand, and assure compliance to and adherence with, the Medicaid enrollment regulations, and related Maryland HealthChoice program policies and procedures related to Maryland HealthChoice member eligibility redetermination and renewals polices.
Notify members, in accordance with ABHMD Policies & Procedures (which reflect Maryland Medicaid HealthChoice and Maryland COMAR regulations) of their loss of eligibility.
Ensure copies of notices and documentation are filed in Members electronic records.
Cultivate and maintain collaborative relationships - with primary care site partners, FQHC and community-based outreach/enrollment organizations - to engage their assistance in working with members to maintain their Maryland Medicaid eligibility and correct information.
Coordinate with Primary Care Sites when working with members on loss of Maryland Medicaid eligibility.
Thoroughly log all member related interactions into Salesforce for the purpose of accurate tracking and analysis.
Develop a process for effectively identifying members with issues and communicating resolution of the issue.
Complete a Weekly Status Report for Supervisor and ABHMD Managers.
Offer recommendations for improvements in ABHMD practices to enhance service delivery and member satisfaction.
Participate in ABHMD sponsored meetings and events.
Represent ABHMD in the community, when requested & provide other duties as assigned.
Job Requirements:
Minimum Qualifications and Professional Expertise:
Associate's Degree or equivalent experience.
Minimum Years' Experience Required 3-5 years BA/BS Degree preferred.
3
years of healthcare experience 2
years' experience specifically with Medicaid/Medicare program operations 1
years' experience with Medicaid policy, financing, program operations, business requirement development, or systems Experience working with Medicaid eligibility requirements, as well as enrollment, renewal and redetermination related regulations and process.
Experience in customer service, specifically working with low-income and culturally diverse populations or, Medicaid enrolled or eligible individuals in person and on the phone.
Experience working with healthcare systems/services and/or experience working with community organizations, social services and public resources.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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