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Medicare Retention Specialist-Health Plan Place

Presbyterian Healthcare Services
life insurance, paid time off
United States, New Mexico, Albuquerque
1100 Central Avenue Southeast (Show on map)
Nov 08, 2024

Medicare Retention Specialist-Health Plan Place


Requisition ID
2024-43776

Category
Health Plan Service Operations


Location : Name

PMG - Pan American


Location : City

Albuquerque


Location : State/Province

NM

Minimum Offer
USD $19.78/Hr.

Maximum Offer for this position is up to
USD $30.21/Hr.



Overview

Now hiring a Medicare Retention Specialist-Health Plan Place

Supports the team with the retention of members that are enrolled in the Medicare Advantage product. Represents Presbyterian at Health Plan Place, in the community statewide and via phone.
Requires strong communication, independent thinking, organization, decision making and time management skills.
Handles tier one and tier two escalated walk-ins and phone calls regarding members that need health plan support or want to disenroll in plan or have complaints. Uses discretion, independent thinking and decision making to develop solutions to overcome barriers and work with supervisor/manager on process improvement strategies.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

    Full Time - Exempt: Yes
  • Job is based Rev Hugh Cooper Admin Center
  • Work hours: Days
  • Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.


Qualifications

  • High School Diploma. 3 years of customer service experience preferably in managed care or healthcare.
  • Demonstrated abilities through education and/or work experience.
  • Proficient computer skills including, but not limited to Microsoft Word, Excel, Access, Outlook; Adobe Acrobat.
  • Preferred experience using workflow software (like Visio or Blueworks), Business Objects, Facets.
  • Ability to orchestrate multiple activities simultaneously to accomplish a goal, as well as use resources effectively and efficiently.


Responsibilities

  • Provides an exceptional customer service experience to patrons.
  • Communicates with patrons
  • Serves as the liaison with external contractors and internal departments specific to Health Plan Place.
  • Independent problem solving and critical thinking skills
  • Signs up members into programs
  • Resolve conflicts
  • Identify problems, alternatives, and solutions to challenges independently
  • Understands policy and performs work directly related to policies.
  • Required to lift 50 pounds
  • Performs other functions as required


Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.



Maximum Offer for this position is up to

USD $30.21/Hr.


Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.


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