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Insurance Navigation Manager
Job Number: 2024-45950
Category: Administrative Professional
Location: Worcester, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: UMass Chan Medical School
Department: School - Shriver Center - W408200
Job Type: Part-Time
Salary Grade: 46
Union Code: Non Union Position -W60- Non Unit Professional
Num. Openings: 1
Post Date: April 19, 2024

POSITION SUMMARY: 

Under the general direction of the Center Director or designee, the Insurance Navigation Manager provides information, resources, and technical assistance to consumers, providers, educators, employers, and others around issues related to insurance coverage for autism and behavioral health. The Insurance Navigation Manager works as part of a small team, collaborating with other Navigation Managers and community partners.

ESSENTIAL FUNCTIONS:

  • Assist families and providers in understanding health care benefits including autism and behavioral health care in Commercial Insurance policies.
  • Educate members and families on commercial health insurance coverage based on their summary plan descriptions and explain how MassHealth benefits work in conjunction with private health insurance.
  • Provide information on the application process for MassHealth secondary insurance for families with commercial insurance, and help families analyze the cost-benefits of this.
  • Assist with tracking TPLs, Disability supplements, and Premium Assistance Applications.
  • Interact with providers, families, MassHealth staff, insurers, and regulators to resolve issues and barriers related to autism and behavioral health care treatment.
  • Make appropriate referrals to various MassHealth units such as TPL Identification, MassHealth Standard and CommonHealth Premium Assistance, Disability Evaluation Services, as required.
  • Maintain record of calls and follow-ups in secure database.
  • Summarize major issues and/or trends that require higher-level resolution.
  • Attend meetings with partners and prepare reports.
  • Participate in community outreach events, Center events, and public presentations.
  • Assist with grant applications, reporting, and fundraising activities.
  • Adhere to University, State and funding agency policies and procedures.
  • Other duties and/or projects as assigned.

REQUIRED QUALIFICATIONS:

  • Masters degree in Business, Law, Public Health/Education, or related health care field; or equivalent.
  • 5 years experience in Business, law, project management, grant submission, supervision of staff, and fiscal responsibility
  • Experience working in and/or with consumers, providers, educators, and others.
  • Familiarity with the policies and procedures of funding agencies
  • Ability to effectively communicate with diverse faculty
  • Proficiency or willingness to learn multiple software and communication platforms.
  • Proven administrative and management ability in complex environments
  • Excellent writing, editing, communications, interpersonal, and organizational skills
  • Ability to travel to off-site locations

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UMass Chan Medical School was among 23 companies that stood out as 2023 “DEI champions,” according to The Boston Globe.   


Named a U.S. News & World Report
“2023 BEST MEDICAL GRAD SCHOOL”
for Primary Care and Research