Member Enrollment Representative I

Site: Mass General Brigham Health Plan Holding Company Inc.

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham we are on the forefront of transformation with one of the worlds leading integrated healthcare systems. Together we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries and a benefits package with flexible work options career growth opportunities and much more.

As part of the Member Enrollment Team you will be responsible for the enrollment tasks primarily for the Medicaid line of business which includes the entry of information into MGBHPs enrollment system and working with reports to resolve discrepancy issues. As business need requires you will provide back up support for other lines of business such as commercial.

As an enrollment representative you will have many interactions with internal and external clients as well as group administrators therefore excellent customer service skills are essential. Other duties include assisting with monthly reconciliation assisting on special projects as needed and researching discrepancy addition you will also help with other general administrative duties and special projects as assigned. The ideal candidate has experience with member enrollment for Medicaid members in QNXT.


Essential Functions
Dealing with complex enrollment issues from either internal representatives external vendors or sales and account executive staff. These issues include but are not limited to eligibility pharmacy billing and group set up
Provide back up support for daily operations in team members absence
Responsible for navigating various systems (QNXT Revs GIC Magic etc) to resolve member issues
Responsible for understanding the distinction between different lines of business (Medicaid Commercial C-Chip C-Choice etc.)
Meet or exceed daily productivity goals
Meet or exceed monthly QC goal
Responsible for reviewing daily error reports.
Participating and engaging in all team meetings
Attend meetings/represent the department on projects as needed
Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains effective relationships within the organization
Hold self and others accountable to meet commitments
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise
Other duties as assigned with or without accommodation

Education

• High School Diploma or Equivalent required and Associates Degree Healthcare Administration or the equivalent combination of training and experience preferred

Experience

• At least 1-2 years of experience in a customer service administrative or enrollment role required
• Member enrollment experience highly preferred
• QNXT experience highly preferred

Knowledge Skills and Abilities

• Demonstrate Mass General Brigham Health Plans core brand principles of always listening challenging conventions and providing value
• Bring fresh ideas forward by listening to and working with employees and the people we serve
• Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner
• Strong demonstrated track record of an ability to execute on time
• Strong aptitude for technology-based solutions
• Ability to inject energy when and where its needed
• Current in healthcare trends
• Demonstrated forward visionary thinking; ability to see what is and envision what could be
• Ability to develop introduce defend and gain support for a new ideas and approaches
• Ability to translate and communicate complex topics in a variety of forums
• Strong verbal active listening and written communication skills required
• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy
• Excellent interpersonal skills including the ability to influence others at all levels of an organization
• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback
• Unquestionable integrity

Working Conditions

• This is a remote role that can be done in most US states
• This is a Monday through Friday role and the schedule will likely be 8 AM - 4:30 PM ET

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$19.42 - $27.74/Hourly

Grade

3

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Health Plan Holding Company Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework