A bit about us:
Were on a mission to change healthcare how its paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being.
Thats why were gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company one that combines compassion, health insurance, clinical care, and technology seamlessly.
"We want to partner with people we love for a cause we believe in. Life is short. Join us."
Make a difference... a big difference. You will have the opportunity in a unique and dynamic culture to be a part of something incredibly meaningful. Were a disruptive startup with an inspiring mission. Learn and grow alongside our world-class team of healthcare, technology, and data leaders, dedicated to building a health plan and clinical services that care for everyone like they were members of our own family. Our team and board members have decades of experience in health care entrepreneurship, data, technology, services, and policy. With their support, we are building a health plan and clinical services that will give seniors easy access to the high-quality care they deserve.
A bit more about this role:
The Membership Operations Analyst works collaboratively with the team to execute the day-to-day business processes required to support the delivery of critical health services: enrollment, membership maintenance, and financial transactions impacting Devoted Health members. In this role you will demonstrate compliance with the Centers for Medicare and Medicaid Services guidance, state Medicaid regulations, Devoted Health policy and Membership Operations procedures/protocols.
As Membership Operations Associate, you will collaborate with designated staff from Devoted Product, Engineering, Data Science and Integration teams to develop and enhance solutions to improve processes. As well, you will directly support our internal partners: Marketing, Agent Support, Telesales, Guides, Claims, Provider, Pharmacy and Risk Adjustment.
Responsibilities will include:
- Develop a working knowledge of applicable federal and state laws, regulations, CMS policy guidance and contract standards.
- Receive and respond to a high volume of incoming requests related to: eligibility, enrollment, premium, demographic status and other health insurance.
- Communicates effectively, verbal and written responses are accurate, thorough and documented with an appropriate level of detail.
- Monitors system queue(s) to submit timely and accurate transactions to the Centers of Medicare and Medicaid Services.
- Investigate and process member and payment issues impacting access to care, billing, cancellation, creditable coverage and disenrollment to ensure compliant resolution.
Attributes to Success:
- Subject Matter Expert in one or more areas: Enrollment, Correspondence, Premium Billing, Coordination of benefits, Data analysis/integrity, quality assurance/monitoring and audit preparation
- Highly organized and detail-driven
- Compliance-driven; works well in a fast-paced environment with firm deliverables and timeframes
- Curiosity to recognize process deficiencies, recommend improvements and implement solutions.
- Flexibility and willingness to change according to business needs
- Compassion for healthcare challenges facing the Medicare population
- Ability to accommodate overtime and/or a rotating schedule in accordance with work volume demands.
Desired skills and experience
- Ideally 1-3 years experience or equivalent professional experience
- Ability to work in a start-up, fast-paced environment
- Bachelors degree or in the process of obtaining
- Knowledge of Medicare Operations guidance
- Demonstrate the ability to achieve short term goals in 4-6 week intervals Strong communication
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoteds Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.