• Program Coordinator

    Healthfirst (WV)


    Duties & Responsibilities:

    + Verifies reward requests based on required preventive services appropriate for the members age, gender and other accepted demographics as outlined via the Member Reward Card Program Guidelines, HEDIS/QARR Technical Specifications, and CMS/DOH guidelines

    + Conducts member and provider outreach to inform on reward guidance and status using multiple internal systems and applications

    + Collaborates with internal and external teams to track and document program requirements and implementation status

    + Documents, communicates and presents technical improvement findings and recommendations in all systems supporting Member Rewards Program

    + Provides support in creating, editing and communicating member and provider material updates

    + Additional duties as necessary

    Minimum Qualifications:

    + High School/GED Diploma from an accredited institution

    + Basic knowledge of MS Word, Excel, Access, and Outlook

    + Strong organizational skills

    + Good communication (verbal and written) and interpersonal skills

    + Flexibility, reliability, and easily adaptable to any work assignments or new computer applications

    + Competent in managing responsibilities in a high-volume and fast-paced environment

    + Ability to resolve member issues with patience and courtesy

    Preferred Qualifications:

    + Associates degree from an accredited institution + 2 Years Work Experience.

    + Experience processing reward card requests highly preferred.

    + Bilingual in English and one or more language(s): Spanish, Mandarin, Cantonese may be required based on business needs

    + Familiarity with some medical terminology.

    + Experience addressing member inquiries in a managed care environment.

    + Knowledge of CPT and ICD-9 codes.

    **Compliance & Regulatory Responsibilities:** Noted above

    License/Certification:** **N/A

    WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.