REMOTE Benefits Support Specialist

Job Description

• Collaborate with contracted vendors to ensure smooth execution of program services.
• Monitor vendor performance, adherence to contract terms, and service level agreements.
• Establish and maintain strong working relationships with vendors through regular communication and meetings.
• Address any vendor-related concern promptly and ensure compliance with program standards.
• Act as the point of contact for program beneficiaries regarding inquiries, issues, and escalations.
• Investigate and resolve member concerns in a timely and satisfactory manner.
• Collaborate with cross-functional teams to address and resolve complex member issues.
• Analyze root causes of member complaints and work on preventive solutions.
• Ensure compliance with regulatory guidelines while resolving member issues.
• Analyze program data to identify trends, patterns, and areas for improvement.
• Prepare regular reports on program performance, member feedback, and vendor compliance.
• Make recommendations based on data analysis to enhance program effectiveness.
• Maintain open lines of communication with internal teams, vendors, and program beneficiaries.

Skills and Requirements

• Experience supporting Medicare Advantage, D-SNP, integrated Medicare-Medicaid plans, supplemental benefits, or NationsBenefits/vendor-administered programs.
• Knowledge of CMS supplemental benefit and SSBCI requirements; familiarity with benefit configuration, eligibility files, vendor testing, reporting, invoice reconciliation, ServiceNow, Facets, CRM, or comparable systems.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [email protected].