What are the responsibilities and job description for the Member Liaison position at MedPOINT Management?
Job Description
Job Description
Summary
The UM Member Liaison acts as an advocate on behalf of the member to address any concerns or questions they may have regarding their medical care relationship(s) with providers. The Liaison also works closely with the health plans with member assignment and access to care. The UM Member Liaison reports directly to the Outpatient UM Lead.
Duties and Responsibilities
- Assist members on realigning to a new Health Plan or Primary Care Physician (PCP)
- Notify Health Plan or state entity when members are outside of the county area or move out of state
- Educates members and their families re : managed care process and Health Plan Options / Programs
- Verifies health insurance coverage for members
- Facilitates communication between members and their physicians
- Submit request to health plan to realign member when PCP requests dissolution from member permanently
- Collaborates with Provider Network Operations team on provider and member disputes
- Assists in special projects, as needed
Minimum Job Requirements
Skill and Abilities
