*Benefits Consultant (Medicaid Retention Specialist)

  • Sector: MRS Pharmacy
  • Contact: Ojas Koolwal
  • Client: Medical Recruitment Strategies
  • Location: Crownsville, United States of America
  • Salary: Negotiable
  • Expiry Date: 27 June 2022
  • Job Ref: BBBH375653_1652717555
  • Contact Email: okoolwal@medicalrecruitmentstrategies.com

**** This is an urgent need.!!! ****

Job Description:

NOTE: Remote with the future possibility of on site

As Benefits Consultant (Medicaid Retention Specialist), you will:

* 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 re determination 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.
* 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.

Preferred Qualifications:

* 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 re determination 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.


M-F 8:30 AM - 5:00 PM EST