QM Member Liaison Nashville TN

Company Name:
UniCare Life & Health Insurance Company
Job Description
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Amerigroup, a proud member of the WellPoint family of companies,is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities. Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
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_QM Member Liaison - Nashville, TN - #87787_
Responsible for member retention by investigating and leading the resolution of member complaints.
Serve as a liaison/mediator between member, the provider and Plan, Provide education to the member on Medicaid Managed Care and their benefits with AMERIGROUP, informing and ensuring that members are aware of their rights and responsibilities, the complaint process, and health education activities available in the community.
Support member outreach activities.
Job Qualifications
Requires 1-3 years experience in a social or health related service-oriented industry. Experience with complaint/grievance processes Previous experience in a Medicaid Managed Care Health Plan preferred. Successful record of community volunteer work. Previous experience in outreach to members to include resolution of issues. Excellent interpersonal, organizational, problem solving, multitasking, analytical and communication skills. Excellent Customer Service skills. Professional telephone etiquette.
EOE.M/F/Disability/Veteran
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.

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