The Member Services Advocate handles inbound calls to address inquiries regarding health insurance benefits, claims, and eligibility while navigating complex healthcare systems. They act as a brand ambassador to resolve member issues, ensure compliance with regulations, and contribute to continuous improvement initiatives.
The Senior Manager leads the strategy, operations, and transformation of broker and employer servicing functions to ensure an exceptional customer experience. This role drives operational excellence, digital adoption, and cross-functional collaboration to meet enterprise growth and retention goals.
The Nurse Care Manager performs holistic assessments and develops individualized care plans to facilitate member wellness and effective transitions of care. They collaborate with interdisciplinary teams and providers to ensure quality medical care and proactive condition management.
The RN Care Manager performs holistic member assessments and develops individualized care plans to facilitate timely care management and transitions. They collaborate with interdisciplinary teams and providers to ensure quality medical care and support optimal wellness for members.
The Eligibility Representative provides guidance and enrollment assistance to individuals eligible for MassHealth and Medicare programs. They are responsible for generating leads, conducting community outreach, and supporting members through the application and renewal processes.
The Government Affairs Analyst will analyze federal legislation and regulations to assess their impact on the organization while collaborating with business leaders to develop policy positions. They will also serve as a subject matter expert, providing technical support and communicating complex policy guidance to senior leadership.
Handle inbound calls to assist members with health insurance benefits, claims, and eligibility while navigating the healthcare system. Act as a member champion to resolve issues internally and externally with providers and employers.
The role is responsible for evolving and maintaining the Disaster Recovery framework, plans, and standards to ensure organizational resilience. This includes coordinating DR testing, tracking remediation of gaps, and reporting readiness maturity to leadership.
Manage cross-functional programs and vendor operations to ensure effective workflows and timely processes. Lead project planning, perform impact analyses, and make data-driven recommendations for policy and process improvements.
The Care Manager ensures members receive timely care management, including transitions of care, complex case management, and chronic condition interventions. They collaborate with members, caregivers, and providers to develop and implement member-specific plans of care to improve health outcomes.
