Location: Nashville, TN
Remote Work Option: No
Shifts: Various shifts available
The Case Management Analyst \- III will be a part of a team supporting development and implementation of case analysis work for reconciliation of data from the health insurance exchanges\. The Analyst is responsible for efficient and timely hands\-on troubleshooting, remediation, coordination, escalation, tracking and management\. Responsible for conducting research, workflow investigations, business procedures and making recommendations\.
The Case Management Analyst \- III will also be responsible for continuous process improvement of the reconciliation process\. He/she will provide content to and for collaboration with training staff on training stakeholders on triaging transactions and the reconciliation process\.
Employee is expected to undertake any additional duties as assigned by Manager\.
+ Gather information from consumers and apply triage, research, collaboration, and policy knowledge to resolve the consumers Marketplace enrollment and processing issues
+ Inform consumers of the results of their 1095\-A Correction Request
+ Understand and properly use and interpret various federal policies, regulations, and systems in response to consumer inquiries about Marketplace enrollment issues
+ Follow all call scripts, Standard Operating Procedures, and knowledge articles when responding to caller inquiries about enrollment or 1095A issues
+ Have knowledge of all major Cognosante HDC operating systems
+ Identify processing deficiencies and initiate corrective actions to improve work processes
+ Manage daily personal voicemail and consumer callbacks
+ Explore answers and alternative solutions to consumer issues; implements solutions, escalates unresolved problems
+ Answer consumer inquiries by researching, locating, providing desired information
+ Inform clients of enrollment issue resolution by explaining procedures; answering questions; providing information
+ Maintain and improve quality results by adhering to standards and guidelines; recommending improved procedures
+ Update job knowledge by studying new scripts; participating in educational opportunities
+ Effectively communicate with both internal and external clients
+ Provide exceptional customer service
+ Consistently provide accurate and timely documentation of daily activities and results
+ Maintain accountability, reliability and dependability when performing all assigned job duties
+ Participate in training sessions required by the Federal Government and Cognosante
+ Analyze and respond to complex questions relating to program eligibility, plan enrollment, and other policy\-related issues for multiple stakeholders
+ Review Marketplace cases escalated due to complex and multiple policies or issues
+ Provide peer review
+ Respond to complex questions relating to program eligibility, plan enrollment, and other policy\-related issues
+ Review regulations and other policy documents from Centers for Medicare & Medicaid Services \(CMS\) to assess impact to business operations, including processes and communications
+ Work with Casework Supervisor to summarize and present extremely complex and unique cases to internal stakeholders and/or CMS representatives for clarification and guidance during Case Review Sessions
**Candidates that do not meet the required qualifications will not be considered\.**
+ Bachelor's degree \(B\.A\.\) from four\-year college or university or 2 years of college \+ 2 years’ experience relative to the specific position or 4 years’ experience relevant to the specific position
+ Must be proficient in word processing, spreadsheet, e\-mail, database, contact management, internet
+ Must have excellent communication, problem solving, and customer service skills
+ Must be proficient in project management software, as well as Visio
+ Must have familiarity with project management tools and methodologies
**Additional Minimum Qualifications**
+ Assisting individuals with enrollment into health insurance coverage, working with in\-person assisters, or researching Marketplace eligibility and enrollment processes and policies
+ 4 or more years of additional experience working with consumers in the Marketplace or other health insurance programs such as Medicaid and the Children’s Health Insurance Program
+ 3 or more years of customer service experience working within a high profile and high\-volume call center
+ 2 or more years of experience with handling and analysis of documentation that impact eligibility such as federal tax returns, 1095\-As, eligibility and determination notices pushed by different health insurance or and or social service programs\.
+ Experience in enrollment transactions
+ Experience with Affordable Care Act
+ Strong written and oral communication skills
+ Advance and demonstrated breadth and depth of experience concerning coordination with other social service programs that impact consumers’ eligibility and enrollment outcomes when applying for health coverage via the Marketplace
+ Advanced customer service telephone skills and the willingness to make outbound and receive inbound telephone calls
+ Proficiency in Microsoft Word, Excel, Power Point, SharePoint
+ Experience with Federal contracts desired
+ Experience with 834 enrollment transaction process desired
## **We’re on a mission to transform our country’s healthcare system\.**
Each of our 1,700\+ colleagues across the United States plays a role in transforming the lives of millions of Americans\. This mission drives us \- and it adds meaning to what we do, each and every day\. Our passion for serving public health programs, and for engaging consumers more directly with the healthcare system, runs deep\.
**Passion for what we do\. Pride in how we do it\.**
Cognosante was founded to address a critical gap in the health IT market – the need for a smart, nimble company, unencumbered by legacy systems and unafraid to challenge accepted wisdom\. Experience grounds us; innovation drives us\. For almost 30 years, we’ve worked to find progressive solutions to complex problems\.
### We help state Medicaid agencies navigate healthcare reform\. We provide community\-based assistance to Americans as they enroll in healthcare coverage\. And we dream of, design, and develop IT solutions meant to disrupt the status quo and connect the dots between patients, plans, providers, and payers\. We are the best minds on health \- and we’re looking to grow our team\.
## Are you ready to make a difference in the lives of millions? Join us\.
### **Highlighted Benefits for Full\-time Employees**
### •Medical • Dental • Vision • 401k • Flexible Spending Accounts • Paid Time Off • Work/Life Solutions • Pet Insurance
**C** **ognosante is an equal opportunity employer\. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics\. Cognosante is committed to working with and providing reasonable accommodations to individuals with disabilities\. If you need a reasonable accommodation because of a disability for any part of the employment process, please send an e\-mail to jobs@cognosante\.com or call 703\-206\-6015 and let us know the nature of your request and your contact information\.**