Mca Eligibility Team Member Ii

Organization:

SHSO-Population Health Services-Valley

Position Overview:

Analyzes monthly eligibility activity reports, reconciles current member lives reported by the various health plans. Responsible for knowing the contractual language stipulated in the health plans contracts as it relates to the management of the membership lives for all clients and all health plans. Assigns and maintains monthly membership lives appropriately to Primary Care Physicians (PCPs) based on health plan eligibility files and/or PCP open/closed rosters. Accurately updates, maintains, and retrieves eligibility information within Sutter Health's database.

Job Description:

EDUCATION:

• HS Diploma or General Education Diploma (GED)

TYPICAL EXPERIENCE:

• 1 year of recent relevant experience.

SKILLS AND KNOWLEDGE:

• Customer service communication and proper telephone etiquette skills.
• Computer and intermediate data entry skills required.
• Analytical skills in abstracting and compiling enrollment and capitation data using Access and Excel programs.
• Must be detail oriented and have written and verbal skills.
• Skills in data collection techniques and record keeping, demonstrating attention to detail and consistent follow through.
• Basic math skills required.
• Ability to work independently with minimal direction.
• Ability to operate a facsimile machine and copier.
• Ability to work as a Team Member to meet contractual deadlines.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

This position is work from home eligible.

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

1

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $26.14 to $37.91 / hour. Colorado, Florida, Georgia, Illinois, Michigan, Nevada, North Carolina, Oregon, Pennsylvania, Texas Pay Range is $23.53 to $34.12 / hour. Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, South Carolina, Tennessee, Utah Pay Range is $20.92 to $30.33 / hour.

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.