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Lisa Hing, Human Resources
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Position Title: Member Services ENrollment Specialist
Position Requirements: Full-Time Position

Caidan Management Company is currently seeking a qualified individual for the position of Member Services Enrollment Specialist.  This position is responsible for enrollment, administrative disenrollments, verification of eligibility, group and auto-assignments and all other procedures relating to the enrollment/disenrollment process for all lines of business within Caidan Management.

The responsibilities of this position include:

• Oversees the preparation, processing and maintenance of new members and re-enrollment.
• Responsible for verifying eligibility for every department and updating MCS accordingly.
• Understands CHAMPS and the CRM system.
• Responsible for notifying the State of the Plans Newborn enrollment.
• Responsible for notifying the State of the Plans deceased membership.
• Responsible for notifying the various SNF’s of membership that should be disenrolled.
• Responsible for verifying and correcting all eligibility issues that occur each month.
• Completes all projects as needed for other members of the department when researching eligibility issues.
• Responsible for all group assignments coordinated with Provider Services department.
• Responsible for monthly auto-assignments coordinated with IS department.
• Responsible for collecting and transmitting data elements specified by CMS for the purpose of enrolling and disenrolling beneficiaries in accordance with CMS Eligibility Enrollment and Disenrollment guidelines.
• Maintains strict confidentiality of member information in accordance with Caidan/HIPAA Privacy Policies.
• Performs other duties as assigned.

The ideal candidate must have a High school diploma, Bachelor’s degree preferred. Two/five years experience in a Managed Care setting. Two years of experience with HPM’s managed care system (MCS) preferred. Experience entering data into the State of Michigan CRM system. Working knowledge in Microsoft Office applications (Outlook, Word, Excel, etc.).  Knowledge of customer relations and team participation.

Position Reports To: Director of Member Services