- 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.
- 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.
- Application for DEA is required
- Completion of a Masters Degree level Family Nurse Practitioner program with current National Board Certification and State of Employment license to practice in the Advanced Practice Nurse role required.
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Benefits Consultant II - BWI Airport, United States - US Tech Solutions
Description
Job Title:
Benefits Consultant II - Medicaid Eligibility Retention Specialist
Location:
Linthicum, MD, Onsite)
Duration: 3 months contract
Job Description:
Medicaid Eligibility Retention Specialist to work with and assist current 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.
Responsibilities:
Experience:
Associate's Degree or equivalent experience.
Skills:
Education:
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
US Tech Solutions is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Recruiter Details:
Name:
Rashi
Email:
Internal Reference Id:
#J-18808-Ljbffr
