Member Services Transition Specialist (Hybrid)

Transition Specialist

VillageCareMAX - 112 Charles Street, New York, NY 10014

VillageCareMAX is looking for a motivated individual with strong Healthcare experience for our Full Time Transition Specialist position. This role is responsible for ensuring that authorizations for new enrollments are entered timely and accurately per the enrollment assessment and proposed plan of care. You will be part of a supportive team environment, assisting members in accessing services, solving problems and communicating with other members of the Care Team.

As the Transition Specialist, you will be responsible for assisting members in accessing all necessary covered services. You will oversee authorization, coordination, fulfillment, reporting, monitoring and tracking of services covered by the plan. You will verify health insurance coverage through ePaces and Care Management System while entering new authorizations for enrollees prior to the enrollment effective date, ensuring appropriate coding of services. You will support our members in many ways, such as assisting members in selection of participating providers and post-enrollment orientation activities, including orientation of members, members' families or representatives.

We would like to speak to those who bring a minimum of 3 years of job-related experience. Prior plan experience will be vital to directing and guiding this role. Demonstrated experience with PC's and related software including Windows & Microsoft Office Suite along with excellent customer service skills.

There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys highly competitive compensation and benefits package, a 403(b) retirement plan and much more than we would love to speak with you! VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care. VillageCare is a Drug-free workplace. Equal Opportunity Employer.