Member Engagement & Benefit Liaison

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

It is a requirement for the Member Engagement & Benefit Liaison work to be performed 100% on-site at their designated clinic.

Purpose of the job

The Member Engagement & Benefit Liaison is the member’s primary resource for understanding and optimizing the health plan benefits for Prosano Health Solutions. As the patient’s advocate and integral part of the care team, you will educate members about benefit coverage and on-site virtual resources and guide them through navigating insurance. The Member Engagement & Benefit Liaison acts as the key connector for the member in navigating their healthcare in conjunction with their health insurance. The goal is to provide an exceptional and signature experience to all members as they access care and utilize their benefits.

REQUIRED QUALIFICATIONS

Required Work Experience

• 2 years of experience in working directly with clients in a clinical or community-based setting

Required Education

• High school diploma or GED required

Required Licenses

• N/A

Required Certifications

• BLS Certification must be obtained within 30 days of hire
• Fingerprint clearance to be obtained within 30 days of hire
• Immunization records or documentation of immunity for all required immunizations must be provided prior to hire or placement in the role. Employees who have not received immunizations for COVID or an annual flu vaccine and have provided documentation of an exception for medical or religious reasons will be required to wear a properly fitting mask while in any Prosano Clinic or as required by management.

PREFERRED QUALIFICATIONS

Preferred Work Experience

• N/A

Preferred Education

• N/A

Preferred Licenses

• N/A

Preferred Certifications

• N/A

ESSENTIAL job functions AND RESPONSIBILITIES

• Translate and distill complex healthcare and insurance information into easily understandable and digestible directions for members
• Operate with flexibility to meet needs of the patients/members by being open to work at different locations when needed.
• Consult and communicate with the Care Team on plan specifics for member care and case needs
• Inform and equip Care Teams with plan specifics and any ongoing changes to the benefit design team
• Work with product, network, and benefits design leads to stay informed and provided feedback for benefit enhancements
• Be the expert around member’s care and their Prosano Health Solutions utilization
• Serve as internal resource in the care center regarding insurance questions for care team
• Schedule appointments with members if a care need is identified during a service call
• Support the care center management team on operational activities, as needed, including scheduling and billing, notifying the care team of any issues or nuances of a patient/member, etc. 
• Provide an exceptional and signature customer experience, educating members on health plan benefits and care center offerings to create an unmatched patient experience
• Act as an ambassador in the local community; while nurturing relationships with other healthcare providers, social/community organizations, and marketing partners
• This role with be part of a matrix reporting structure with support from Blue Cross Blue Shield of Arizona and Prosano Health Solutions leaders
• Support care center management developing and leading member engagement campaigns, and activities or other special projects and initiatives targeting engaged and unengaged members
• Maintain current documentation and stay familiar with current procedural policies for appropriate computer system, coding guidelines and contract benefit changes
• Act as the liaison between Prosano Health Solutions and BCBSAZ regarding policies and procedures, system updates and service disruptions that directly and indirectly impact members 
• Serve as lead in monitoring and facilitating remediation of service recovery for health plan and care center
• Facilitate and archive Prosano Health Service Bulletins for key knowledge sharing between the service and care teams for staff awareness of member impact issues, new policies, procedures, and processes
• Other duties as assigned

REQUIRED COMPETENCIES

Required Job Skills

• Community health experience
• Health plan customer service experience

• Proficient PC skills
• Customer service orientation and experience

Required Professional Competencies

• A problem-solving orientation and a flexible and positive attitude
• Strong communication skills across multiple modalities
• Empathy and advocacy

Required Leadership Experience and Competencies

• N/A

PREFERRED COMPETENCIES

Preferred Job Skills

• N/A

Preferred Professional Competencies

• Fluency in Spanish or other languages commonly spoken by people in the communities we serve preferred, where necessary

Preferred Leadership Experience and Competencies

• N/A

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.