DESCRIPTION/RESPONSIBILITIES:
Provide functional technical and analytical support to BCN Advantage department. This may include problem identification and resolution, documentation, analysis, recommendation, and implementation of new or enhanced work processes, systems, and reports.
Provide support to assigned departmental leadership through technical, analytical and subject matter knowledge.
Research problems reported by other staff; evaluate possible corrective actions, recommend and implement solutions.
Investigate and respond to inquiries from other internal departments and external entities.
Develop and implement changes to processes and procedures to correct and improve business unit performance. Assist in documenting departmental procedures.
Test and document new and modified system changes. Update departmental processes, monitor error and compliance reports to support departmental performance and to ensure adherence to goals, internal and external customer expectations, and requirements from external entities such as CMS, BCBSA and other regulatory agencies.
Participate on special projects or workgroup as assigned.
The incumbent must have a sound[DEL: :DEL] understanding of the BCN Advantage product and how it relates to expansion of new memberships and the retention of existing members. Knowledge base must include comprehension of customer service and enrollment processes, Facets, and Express Scripts.
This position directly supports the project/process initiatives that directly impact BCNA service levels for both customer service and enrollment. There is extensive interaction both within the entire department, with other BCNA/BCBSM departments and with external parties (CMS, providers, members, agents, groups, senior advocacy representatives, etc.)
A major aspect of the position is working on reports, both systems generated and as requested by CMS and/or BCNA.
DEPARTMENTAL REQUIREMENTS:
* Working knowledge of Microsoft Access
DEPARTMENTAL PREFERENCES:
* Membership and product knowledge preferred.
* Knowledge of Medicare Advantage products and CMS regulations preferred.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, protected veteran status or status as an individual with a disability.
