OHIM Carrier Relations and Enrollment Specialist
About the position OHIM seeks a Carrier Relations and Enrollment Specialist that will support the Consumer Experience Manager and the Carrier Relations and Enrollment Manager in case management work. The position will perform casework that is escalated from the CoverME.gov Consumer Assistance Center and numerous health insurance carriers. A core component of this role is to perform monthly carrier reconciliation to resolve all Marketplace enrollment discrepancies and work with the carriers to resolve their discrepancies. This position will report directly to the Carrier Relations and Enrollment Manager.
Responsibilities
- Performing consumer casework related to eligibility and enrollment
- Serving as a liaison to the health insurance carriers on CoverME.gov
- Comparing and analyzing large sets of complex data
- Working with the carriers to complete annual plan, benefit, and rate testing
- Assisting in User Acceptance Testing (UAT) for defects, system enhancements, features, and functionality
- Other duties as assigned.
Requirements
- A Bachelor’s Degree in Public/Community Health, Health Administration, Health Sciences or Health Education; Public Administration, Government, Social Work, or a closely related field and three (3) years professional experience in the planning, development, coordination and/or evaluation of health programs or services -OR- an equivalent seven (7) year combination of education, training, and experience.
Nice-to-haves
- Experience in customer service, data analysis, program evaluation or health care or insurance programs or services is highly preferred.
Benefits
- Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave , and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
- Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($12,845.82 - $15,112.76 annual value), depending on salary.
- Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%.
- Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($395.72 annual value).
- Retirement Plan – The State contributes the equivalent of 14.11% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).
- Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave . Additional, unpaid leave may also be available, under the Family and Medical Leave Act .
- State employees are eligible for an extensive and highly competitive benefits package , covering many aspects of wellness.
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