Member Experience Specialist at Upper Peninsula Health Plan

POSITION: Member Experience SpecialistDEPARTMENT: Strategic InitiativesBASE RATE: $20.41 per hour with potential for additional compensation based on qualifications.POSITION SUMMARY:This position coordinates and prepares external communications for Upper Peninsula Health Plan (UPHP) members and providers. This position also facilitates government program enrollment and membership activities including grievance resolution. The Member Experience Specialist completes tasks and duties in accordance with established goals objectives and standards of the Upper Peninsula Health Plan.ESSENTIAL DUTIES AND RESPONSIBILITIES:1. Follows established UPHP policies and procedures objectives safety standards and sensitivity to confidential information.2. Maintains knowledge of regulatory communications and marketing guidance including but not limited to Centers for Medicare and Medicaid (CMS) Managed Care communications and marketing guidelines CMS plan communication user guide (PCUG) and Michigan Department of Health and Human Services (MDHHS) marketing requirements and guidelines.3. Develops and coordinates interdepartmental reviews of major member materials such as Annual Notice of Change (ANOC) summary of benefits (SB) enrollment and disenrollment documents member handbooks and newsletters; responsible for the development and submission of member materials for all UPHP lines of business.4. Conducts member outreach as needed.5. Coordinates Medicare enrollment/disenrollment processes. Ensures enrollment process timeline parameters are met and daily Transaction Reply Reports (TRR) are addressed timely.6. Responsible for investigation and timely resolution of member grievances for all lines of business. Compiles data analyzes and drafts grievance reports for CMS MDHHS and Department of Insurance and Financial Services (DIFS).7. Processes returned member mail in accordance with applicable rules and regulations.8. Reviews and demonstrates knowledge of National Committee for Quality (NCQA) measures and assists in NCQA evaluation activities related to member rights responsibilities and member experience.9. Supports the Enrollee Advisory Committee including member recruitment agenda development meeting facilitation and reporting; serves as committee secretary and maintains meeting minutes.10. Supports the Service Advisory Committee (SAC) including agenda development meeting facilitation and reporting; serves as SAC secretary and maintains meeting minutes.11. Facilitates creation of provider newsletters in collaboration with appropriate staff.12. Facilitates the UPHP policy maintenance process; ensures all policies are up-to-date available to staff and retained as required.13. Coordinates the submission of Michigan Department of Health and Human Services (MDHHS) contract deliverables.14. Facilitates interdepartmental workgroup to ensure the UPHP website is up-to-date.15. Performs the day-to-day tasks required to support the Strategic Initiatives Department which includes but is not limited to report drafting/review document and project management and government program document maintenance.16. Enhances professional growth and development through participation in education programs current literature in-service meetings and workshops.17. Maintains confidentiality of client data.18. Performs other related duties as assigned or requested.POSITION QUALIFICATIONS:Education:Minimum:Associate degree in health information processing business or health-related field; four (4) yearsof relevant experience in lieu of a degree will be considered.Preferred:Bachelors degree in business health education communications or other health-related fieldExperience:Minimum:Two (2) to three (3) years of insurance marketing or health-related customer service/education(or combination of education and work experience)Preferred:Three (3) to five (5) years of insurance marketing or health-related customer service/education;managed care and/or government programs experienceRequired Skills:Keyboarding proficiencyWorking knowledge of MS Office (Word Excel and PowerPoint)Excellent human relation and oral/written communication with advanced knowledge of vocabulary spelling proper grammar and punctuationExcellent organizational abilities with attention to detailProofreading editing and writing skillsResearch and analytical skillsAbility to operate standard office equipment (photocopier/scanner fax etc.)The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards but as general guidelines that should be considered along with other job-related selection or promotional criteria.Physical Requirements:This job requires the ability to perform the essential functions contained in the description. These include but are not limited to the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements:Ability to enter and access information from a computerAbility to access all areas of the UPHP officesOccasionally lifts supplies/equipmentOccasional reaching stooping bending kneeling crouchingProlonged periods of sittingManual dexterity and mobilityWorking Conditions:Works in office conditions but occasional travel may be requiredSubject to many interruptionsOccasionally subjected to irregular hours and evening meetingsRequired Experience:IC Key Skills Commercial Property Paralegal,JAVA/J2EE,Building Construction,Javase,Administrative Services Employment Type : Full-Time Experience: years Vacancy: 1