Experienced Eligibility Coordinator for Healthcare - Remote Opportunity with iMPROve Health

Join iMPROve Health: Michigan's Medicare-Designated Quality Improvement Organization

iMPROve Health is seeking a highly skilled and dedicated Eligibility Coordinator to join our team as a remote professional. As a nonprofit organization with over 40 years of experience in improving healthcare, we offer a unique opportunity to work with a talented team of healthcare professionals and consultants. Our mission is to help healthcare get better by providing evidence-based strategies and solutions to achieve quality improvement goals.

About Us

iMPROve Health is a Cool Place to Work, as recognized by Crain's Detroit Business for the last four years, and one of the Best Places to Work in Healthcare, as judged by Modern Healthcare. We pride ourselves on providing a great work-life balance for our employees, while also promoting their career development and gain new skills through employee education opportunities. Our team is comprised of healthcare professionals, including physicians and nurses, who work together to promote the adoption and use of evidence-based best practices and processes.

Job Summary

The Eligibility Coordinator is a critical role responsible for managing all aspects of the eligibility process for the NSA Federal & State IDRE programs. This includes analyzing new cases to determine eligibility, developing and implementing eligibility training, and ensuring compliance with federal and state regulations. The ideal candidate will have a strong background in healthcare, excellent project management skills, and the ability to work independently in a remote environment.

Key Responsibilities

• Develops, plans, and implements team eligibility training to ensure that all team members understand the eligibility process and can accurately determine eligibility.
• Analyzes new cases to determine eligibility, ineligibility, or the need for outreach to determine eligibility.
• Manages and processes all incoming and outgoing IDRE Program Case Reviews, ensuring timely and efficient processing.
• Ensures compliance with all applicable federal and state regulations, including HIPAA, FISMA, URAC, and CMS.
• Maintains up-to-date knowledge, training, and adherence to all compliance and regulatory requirements for contracts, governmental, and compliance regulatory organizations.
• Utilizes time and project management skills to ensure assigned activities are completed in a timely manner and in accordance with contract requirements.
• Applies problem-solving abilities to identify, resolve, and/or communicate potential delays or problems in advance of deadlines.
• Accurately and timely enters data into designed CMS system and department database.

Essential Qualifications

To be successful in this role, you will need:

• A Bachelor's degree in a healthcare specialty; Master's degree preferred.
• At least 5 years of project support experience in a corporate/professional environment with a proven record of meeting project deadlines.
• Relevant knowledge of the Federal No Surprises Act.
• Project management skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
• Strong communication skills, both verbal and written.
• Strong multi-tasking skills with attention to detail and deadlines.
• Proficiency in Microsoft Office, including Word, Excel, and Outlook.

Preferred Qualifications

While not required, the following qualifications are preferred:

• Understanding of quality improvement concepts.
• Working knowledge of PowerPoint, Microsoft Access, and Visio.

Skills and Competencies

The ideal candidate will possess:

• Attention to detail: Ability to accurately analyze data and determine eligibility.
• Effective communication: Ability to clearly communicate with team members and stakeholders.
• Collaboration: Ability to work collaboratively with team members to achieve common goals.
• Problem-solving skills: Ability to identify and resolve problems in a timely and efficient manner.
• Time management: Ability to prioritize tasks and manage multiple projects simultaneously.

Career Growth Opportunities and Learning Benefits

At iMPROve Health, we are committed to promoting the career development and growth of our employees. As an Eligibility Coordinator, you will have the opportunity to:

• Develop new skills through employee education opportunities.
• Participate in training and professional development programs.
• Collaborate with a talented team of healthcare professionals and consultants.

Work Environment and Company Culture

iMPROve Health is a remote-friendly organization that values work-life balance. As a remote employee, you will:

• Have the flexibility to work from anywhere within the United States.
• Be part of a talented team of professionals who are passionate about improving healthcare.
• Enjoy a comprehensive benefits package, including medical, dental, vision, life insurance, short-term and long-term disability, and a generous 401(k) match.

Compensation and Benefits

We offer a competitive salary and a comprehensive benefits package to our employees. While the exact compensation details are not disclosed, we can assure you that our package is designed to attract and retain top talent in the industry.

Take the Next Step

If you are a motivated and detail-oriented professional looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity. As an Eligibility Coordinator at iMPROve Health, you will play a critical role in improving healthcare quality and making a positive impact on the lives of others. Apply now and let's discuss how you can become a vital part of our success story.