Member Enrollment Representative I

Massachusetts General Hospital; Somerville (MA); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading healthcare provider is looking for a Member Enrollment Team member to manage enrollment tasks and provide exceptional customer service. The role requires excellent communication skills and the ability to handle complex issues. Ideal candidates have experience in customer service or administrative roles and a high school diploma. This is a remote position with competitive hourly pay and benefits.

Benefits

Flexible work options

Career growth opportunities

Comprehensive benefits

Qualifications

• 1-2 years of experience in customer service, administrative, or enrollment role.
• Ability to develop and introduce new ideas and approaches.
• Current in healthcare trends.

Responsibilities

• Handle complex enrollment issues from internal and external clients.
• Provide backup support for daily operations in team member's absence.
• Meet or exceed daily productivity and monthly QC goals.

Skills

Excellent customer service skills

Strong verbal communication

Demonstrated integrity

Ability to navigate multiple systems

Education

High School Diploma or Equivalent

Associate's Degree in Healthcare Administration

Job description

Overview

Mass General Brigham Health Plan Holding Company, Inc. relies on a wide range of professionals 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.

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 world\'s 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.

Responsibilities

As part of the Member Enrollment Team, you will be responsible for the enrollment tasks primarily for the commercial line of business, which includes the entry of information into MGBHP\'s 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 Medicaid and Medicare. 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 reports. In addition, you will also help with other general administrative duties and special projects as assigned.

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 member's 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

Qualifications

Education

• High School Diploma or Equivalent required and Associate\'s 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

Knowledge, Skills, and Abilities

• Demonstrate Mass General Brigham Health Plan\'s 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 it\'s 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

Additional Job Details (if applicable)

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 Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

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 package. In 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.

EEO Statement:

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 Veteran\'s 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 (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.