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The Member Services Analyst for the Institutional and Institutional Equivalent Special Needs Plan (I/IE-SNP) serves as the primary point of contact for membership operations. This role is responsible for delivering exceptional, person centered service to a uniquely vulnerable population by addressing inquiries related to benefits, authorizations, enrollments, claims, grievances, and appeals in full compliance with CMS regulations and the plan's Model of Care (MOC).
This position collaborates closely with Interdisciplinary Care Teams (ICTs), facility staff, authorized representatives, family members, and internal teams to ensure members concerns are resolved timely.
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We are seeking a remote Medicare Sales Account Representative/Executive for our Abilis Health Plan who will work with senior care partners to assist in enrolling new residents and members. You will actively market our plan to new senior care partners within several of our plan service areas. Regional travel in Kentucky and/or Tennessee is required.
We value candidates with healthcare direct sales and/or account management experience, a KY or TN State Insurance License (or willingness to quickly get one), and experience working with our elder community.
Our base salary includes eligibility for a...
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The Chief Medical Officer (CMO) provides executive clinical leadership for Abilis Health’s Institutional Special Needs Plan (I-SNP) and Institutional-Equivalent Special Needs Plan (IE-SNP) Medicare Advantage products. The CMO is responsible for the strategic direction and oversight of clinical programs including utilization management, clinical operations, quality, population health, and pharmacy operations to ensure safe, effective, and financially responsible care for members in long term care settings. The CMO serves as the senior physician executive, partnering with the CEO and leadership team to drive clinical performance, regulatory compliance, and an integrated model of care for high-acuity, medically complex populations.
iCIMS Application FAQsBrightSpring Health Services, and our family of brands, provides equal employment opportunity