Career Opportunities: Customer Service Member Liaison - Medicare Sales Desk (24553) Requisition ID 24553 - Posted 08/29/2024 - CareOregon - Full Time - Permanent - Portland - Multi Location (11) Job Description Print Preview Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Customer Service Member Liaison - Medicare Sales Desk Exemption Status Non-Exempt Department Member Customer Service Manager Title Customer Service Manager Direct Reports n/a Requisition # 24553 Pay & Benefits Estimated hiring range $51,800 - $63,320 / year, 5% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits Posting Notes This is a fully remote position, but open to Oregon and Southwest Washington residents. Job Summary This position supports members through problem solving and advocacy to improve their customer experience with complex system navigation, Oregon Health Plan (OHP) benefits and eligibility, and provider and health plan assignment issues. This position develops strong working relationships and regular collaborative communication with internal and external teams to resolve individual member issues, as well as to address systemic barriers that are identified. This position also assures members have smooth transitions as needed and provides culturally sensitive information and education to members about their benefits, rights, and responsibilities. Essential Responsibilities Work collaboratively with providers, partners, OHP, plans and members to ensure effective customer service and the resolution of member problems (e.g., claims, eligibility, and system). Serve as primary liaison on escalated issues related to member experience. Connect members with appropriate departments at plan partner organizations. Assure members are carefully transitioned to the correct partners when applicable. Maintain relationships with partners and providers to facilitate positive communication and shared problem solving. Provide proactive value-added service by identifying and reporting system issues. Attend regional meetings to provide updates to Community Partners. Assist leadership with projects intended to foster integration across CareOregon Departments. Educate members on benefits, rights, and responsibilities. Organizational Responsibilities Perform work in alignment with the organization's mission, vision and values. Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals. Strive to meet annual business goals in support of the organization's strategic goals. Adhere to the organization's policies, procedures and other relevant compliance needs. Perform other duties as needed. Experience and/or Education Required Minimum 2 years' experience working in customer service in a health care setting Preferred Experience with Medicare Sales desk experience DSNP experience Experience with CMS rules and regulations Work experience in a similar role within a managed care environment Knowledge, Skills and Abilities Required Knowledge Knowledge of the basic concepts of Managed Care Skills and Abilities Ability to learn and apply Oregon Administrative Rules (OARs), federal laws, and other applicable regulations from agencies that relate to the medical health insurance industry, including Medicaid and Medicare Ability to learn basic knowledge o