Insurance Navigation Manager

4 weeks ago

Worcester, United States InsideHigherEd Full time
Overview

POSITION SUMMARY: 

Under the general direction of the Center Director or designee, the Insurance Navigation Manager provides information, resources, and technical assistance to consumers, providers, educators, employers, and others around issues related to insurance coverage for autism and behavioral health. The Insurance Navigation Manager works as part of a small team, collaborating with other Navigation Managers and community partners.

Responsibilities

ESSENTIAL FUNCTIONS:

  • Assist families and providers in understanding health care benefits including autism and behavioral health care in Commercial Insurance policies.
  • Educate members and families on commercial health insurance coverage based on their summary plan descriptions and explain how MassHealth benefits work in conjunction with private health insurance.
  • Provide information on the application process for MassHealth secondary insurance for families with commercial insurance, and help families analyze the cost-benefits of this.
  • Assist with tracking TPL’s, Disability supplements, and Premium Assistance Applications.
  • Interact with providers, families, MassHealth staff, insurers, and regulators to resolve issues and barriers related to autism and behavioral health care treatment.
  • Make appropriate referrals to various MassHealth units such as TPL Identification, MassHealth Standard and CommonHealth Premium Assistance, Disability Evaluation Services, as required.
  • Maintain record of calls and follow-ups in secure database.
  • Summarize major issues and/or trends that require higher-level resolution.
  • Attend meetings with partners and prepare reports.
  • Participate in community outreach events, Center events, and public presentations.
  • Assist with grant applications, reporting, and fundraising activities.
  • Adhere to University, State and funding agency policies and procedures.
  • Other duties and/or projects as assigned.
Qualifications

REQUIRED QUALIFICATIONS:

  • Masters’ degree in Business, Law, Public Health/Education, or related health care field; or equivalent.
  • 5 years’ experience in Business, law, project management, grant submission, supervision of staff, and fiscal responsibility
  • Experience working in and/or with consumers, providers, educators, and others.
  • Familiarity with the policies and procedures of funding agencies
  • Ability to effectively communicate with diverse faculty
  • Proficiency or willingness to learn multiple software and communication platforms.
  • Proven administrative and management ability in complex environments
  • Excellent writing, editing, communications, interpersonal, and organizational skills
  • Ability to travel to off-site locations

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