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GENERAL SUMMARY OF POSITION:

The Dual Eligible Benefit Specialist is part of the Medicare Eligibility Enhancement Programs (MEEP) Team at the Center for Health Care Financing.  MEEP works with state Medicaid programs to identify and coordinate federal and state benefits for program recipients, helping ensure that individuals receive all benefits to which they are entitled, with a focus on Medicare and Social Security related benefits.  The Dual Eligible Benefit Specialist will assist in the development, implementation, and management of new and ongoing activities and projects to identify, maintain, and coordinate Medicare coverage and support premium payments for Massachusetts Medicaid (MassHealth) members.

Duties may include:

• Coordinate activities with MassHealth business units to ensure benefits for dual-eligible members are administered in accordance with program regulations and policies
• Provide customer service to MassHealth members, providers, and other internal and external stakeholders
• Act as a liaison between MEEP team and MassHealth staff to resolve data discrepancies and system issues impacting member benefits
• Manage project data, including state and federal data sets, to ensure data integrity and security
• Participate in the design, development, and management of project databases, including creating reference tables, writing and executing queries, and producing reports in Microsoft Access and/or SQL environments

MAJOR RESPONSIBILITIES:

• Coordinate and implement new products and projects  
• Perform complex analysis in support of projects in and out of state
• Participate in developing proposal responses by providing documentation and analysis
• Assist in the preparation of client and staff presentations and marketing materials 
• Provide support to staff performing consulting services
• Participate in project forecasting and financial analysis
• Present the research and development findings on industry trends to support cost savings and revenue initiatives
• Assist in the development of agreements between public entities and the University
• Communicate with client as required concerning status of their projects
• Respond to client needs and requests
• Prepare internal and external reports 
• Assist in the design and implement of instruments to quantify and track cost savings and revenue activities 
• Participate in the Continuous Quality Improvement program
• Perform other job related duties as assigned

REQUIRED QUALIFICATIONS:

• Bachelor’s degree or equivalent
• 3-5 years of experience in a business related field or other related experience
• Preferred knowledge of State and Federal regulations as they apply to public assistance programs
• Demonstrated experience in computer based tools including spreadsheets and word processing
• Knowledge of accounting principles, budgeting, and computer reporting preparation
• Demonstrated project management skills

PREFERRED QUALIFICATIONS:

• Demonstrated knowledge of Medicare, Medicare Buy-In, and/or MassHealth eligibility rules, systems, and application/enrollment processes

• Demonstrated experience working directly with health and human service program recipients, agencies, and/or the Social Security Administration on Medicaid, Medicare, and other Social Security benefit eligibility and enrollment activities
• Effective verbal and written communication skills
• Strong quantitative and analytical skills, including demonstrated experience organizing, managing, and reporting on complex data analysis projects

• Demonstrated experience preparing project status and dashboard reports, cost savings and revenue tracking reports, project invoices, and other ad hoc reports
• Experience in developing, proposing, and implementing creative solutions to complex problems

About the Center for Health Care Financing and Medicare Eligibility Enhancement Programs (MEEP) Team

The Center for Health Care Financing (CHCF) is a part of Commonwealth Medicine (CWM), the health care consulting division of UMass Medical School, Massachusetts’ only public medical school. As nationwide leaders in the development and implementation of health care reform, CWM and CHCF stay ahead of health care trends and help strategize and plan for changes that impact both health care delivery systems and patients on the local, state and national level.

Located in Charlestown, MA, CHCF helps state agencies identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs, and capitalize on all possible revenue streams. At the same time, we identify opportunities for our clients to increase health care related services, reduce the net cost of delivery, and help ensure individuals receive the health and human service benefits to which they may be entitled.

The Medicare Eligibility Enhancement Programs (MEEP) Team at CHCF works with state Medicaid programs to identify and coordinate federal and state benefits for program recipients, helping ensure that individuals receive all benefits to which they are entitled.  The MEEP team develops and implements benefit coordination initiatives which achieve cost savings and revenue opportunities for Medicaid agencies by ensuring federal benefits are appropriately identified and coordinated for state program recipients.

MEEP focuses on identifying and coordinating eligibility for Social Security, Medicare, and Medicare Buy-In benefits for state Medicaid recipients.  Current activities include identification of Medicare benefits, assistance with the Medicare application and enrollment process, review of eligibility for Social Security benefits, and reconciliation of state Medicare premium payments. MEEP currently works with state Medicaid agencies in four states.

This position is in the Schrafft's Building, located in Charlestown, Massachusetts, just north of Boston and easily accessible by public transportation.