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Case Management Analyst IV job

CognosanteAlexandria, TN
Cognosante jobs

Company

Salary

Skills

Benefits

Job Description

Cognosante is on a mission to transform our countrys healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisition support to application development, data integration, data standards, and business process operations. Learn how we are making a difference in peoples lives today!

Job Description

The Case Management Analyst - IV 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 - IV 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.

Key Responsibilities

  • 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

  • Review and create all application modifications (834s) required for case resolution

  • Work with Casework Supervisor to conduct trainings as needed

  • Serve as subset of Policy SMEs in addition to the Team Lead and Manager

  • Provide updates and oversight on ISO certified project policy and work instruction

  • Work with Team Lead and Manager to coordinate all special projects/tasks

  • Work with Team Lead and Manager to summarize and present extremely complex and unique cases to internal stakeholders and/or CMS representatives for clarification and guidance during Case Review Sessions

  • Support Direct Referral cases from CMS that require advanced resolution

Required Qualifications

  • Education: Bachelors degree or 2 years of college and 2 years of relevant experience or 4 years of relevant experience

  • Experience or education with project management tools and methodologies

  • Excellent communication skills

  • Excellent problem-solving skills

  • Excellent customer service skills

Additional Required Minimum Qualifications

  • Expert case analysis skills

  • Resolves customer dispute discrepancies

Candidates that do not meet the required qualifications will not be considered.

Preferred Qualifications

  • Experience in enrollment transactions

  • Experience with Affordable Care Act

  • Strong written and oral communication skills

  • 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

Were on a mission to transform our countrys 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. At Cognosante we are all VIPS.

We create value be being enterprising. We develop innovative ideas and solutions. We perform at our best and deliver results. We share achieved results and recognitions.

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, weve 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 were 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

Cognosante is an equal opportunity employer at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm . 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. If youd like to view a copy of the companys affirmative action plan or policy statement, please email jobs@cognosante.com . 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 and let us know the nature of your request and your contact information.

T o all recruitment agencies: Cognosante does not accept unsolicited agency resumes. Please do not forward unsolicited resumes to our requisitions, any Cognosante email address, any Cognosante employee, or to any company location. Cognosante is not responsible for any fees related to unsolicited resumes.

Estimated annual salary
$29,699
average
Minimum
$19,793
Maximum
$42,664

TASKS

  • Prepare and maintain records and case files, including documentation such as clients' personal and eligibility information, services provided, narratives of client contacts, or relevant correspondence.
  • Develop rehabilitation plans that fit clients' aptitudes, education levels, physical abilities, and career goals.
  • Monitor and record clients' progress to ensure that goals and objectives are met.
  • Confer with clients to discuss their options and goals so that rehabilitation programs and plans for accessing needed services can be developed.

SKILLS

  • Reading ComprehensionUnderstanding written sentences and paragraphs in work related documents.
  • Active ListeningGiving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • WritingCommunicating effectively in writing as appropriate for the needs of the audience.
  • SpeakingTalking to others to convey information effectively.

KNOWLEDGE

  • Administration and ManagementKnowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  • ClericalKnowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
  • Customer and Personal ServiceKnowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
  • Computers and ElectronicsKnowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
Vacation & Paid Time OffHealth Insurance
Dental InsuranceVision Insurance
Flexible Spending Account (FSA)401K Plan

Cognosante

Type

Company - Private

Size

Large

Revenue

$100M to $500M

Location

Multiple locations

Industry

Computer/Internet

Founded

2008

CEO

Michele Kang

Job Filters

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SUMMARY Black Turtle Services is a fast-growing start-up that provides multi-channel customer contact management solutions for clients in the US Federal Government and the commercial sector The Customer Service Representative-Bilingual provides information...Read more
Customer Service AgentCognosanteBarbourville, KY
**Security Clearance required:** Cognosante is on a mission to transform our country's healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisition support to application...Read more
Call Center Quality ManagerCognosanteFalls Church, VA
Security Clearance required:No clearance requiredCognosante is on a mission to transform our country’s healthcare system. With our health and security-focused solutions, we help public sector organizations achieve the important task of providing the best...Read more
Sr. Payment SpecialistCognosanteMcLean, VA
**Security Clearance required:** Able to obtain Public Trust Cognosante is on a mission to transform our country's healthcare and safety systems. With our health and security-focused solutions, we help public sector organizations achieve the important task...Read more
Customer Service Representative **Summary** Cognosante is a fast-growing company that provides multi-channel customer contact management solutions for clients in the US Federal Government and the commercial sector. The Customer Service Representative...Read more

Closed Job Filters

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Cloud Engineering ManagerCognosanteMc Lean, VA
Cognosante is on a mission to transform our country's healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisitionRead more
Cloud Engineering ManagerCognosanteMcLean, VA
Cognosante is on a mission to transform our country’s healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisitionRead more
Technical Quality Analyst Bilingual English/Spanish JLodge, a Cognosante Company, is hiring **Bilingual Technical Quality Analysts** to support our customers’ goal of improving and maintaining theRead more
Project ManagerCognosanteMcLean, VA
Cognosante is on a mission to transform our country’s healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisitionRead more
Cognosante is on a mission to transform our country's healthcare system. We are a health IT Company who helps public sector organizations do everything from strategic consulting and acquisitionRead more
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