<p>011120 CCA-Enrollment</p> <p>Position Summary:</p> <p>Retain current members, who wish to remain current members in all of CCA's Products, by preventing or rectifying the disenrollment of members due to loss of Mass Health eligibility.</p> <p>Supervision Exercised:</p> <ul> <li>None </li></ul> <p>Essential Duties & Responsibilities:</p> <ul> <li>Understand, and assure compliance to and adherence with, Medicare & Medicaid enrollment regulations, and related CCA policies and procedures. </li><li>Notify members, in accordance with CCA Policies & Procedures (which reflect Medicare and MassHealth regulations) of their loss of eligibility. </li><li>Ensure copies of notices and documentation are filed in Members' paper and electronic records. </li><li>Cultivate and maintain collaborative relationships - with primary care site partners and community based outreach/enrollment organizations - to engage their assistance in working with members to maintain CCA enrollment and correct information.. </li><li>Coordinate with Primary Care Sites when working with members on loss of MassHealth. </li><li>Thoroughly log all member related interactions into CCA member database for purpose of accurate tracking and analysis. </li><li>Develop a process for effectively identifying members with issues and communicating resolution of the issue. </li><li>Complete a Monthly Status Report for Supervisor and CCA Managers. </li><li>Offer recommendations for improvements in CCA practices to enhance service delivery and member and primary care team satisfaction. </li><li>Help CCA with translation of member materials and interpretation as needed. </li><li>Participate in CCA sponsored meetings and events. </li><li>Represent CCA in the community, when requested. </li><li>Training and coaching of colleagues in the CCA SCO program, when collaborating to retain members. </li><li>Provide other duties as assigned. </li></ul> <p>Working Conditions:</p> <ul> <li>Standard Office Conditions </li><li>This position is 90% in office for telephone contact with members and other stakeholders. </li></ul> <p>Required Education:</p> <ul> <li>Associates Degree with 5+ years of experience </li><li>High School education with equivalent relevant experience. </li></ul> <p>Desired Education:</p> <ul> <li>BA/BS Degree </li></ul> <p>Required Experience:</p> <ul> <li>3-5 years </li></ul> <p>Required Knowledge, Skills & Abilities:</p> <ul> <li>Experience working with Medicare & Medicaid eligibility requirements and enrollment related regulations and process. </li><li>Experience in customer service, specifically working with elders and disabled individuals in person and on the phone. </li><li>Experience working with healthcare systems/services and/or experience working with community organizations, social services and public resources. </li><li>Experience working with low-income, culturally diverse, population. </li></ul> <p>Language(s):</p> <ul> <li>English </li><li>Fluent Spanish oral communication skills a plus. </li></ul>