Eligibility & VAS Coordinator

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.


The Business Program and Analytics Coordinator is responsible for coordinating the eligibility and VAS teams. The coordinator will take direction from MSO management and delegate it to the individual teams, ensuring tasks are completed in an efficient manner. The coordinator will oversee projects improving workflows and strategy for the Eligibility and VAS teams.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.

General Duties:

• Maintains utmost level of confidentiality at all times.
• Adheres to Health System and Health Plan policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• Performs all other tasks as assigned by upper management.
• Performs other duties as assigned by Director of Member Services and Outreach.

Eligibility Responsibilities:

• Coordinates all Eligibility functional, technical and operational activities of the Department.
• Ensures all eligibility related CRMs are worked by the team within the appropriate timelines.
• Answers eligibility related questions from other departments.
• Liaison between the Enrollment Broker, HHSC, Dental and Pharmacy vendors on all eligibility and enrollment matters.
• Ensures staff compliance with HHSC contractual requirements and URAC standards.
• Collaborates with Management to increase eligibility and enrollment metrics, by identifying trends, communicating changes, and driving the feedback process.
• Analyzes reports, understand trends, forecast changes and develop action plans in response.
• Assists Tapestry team and Data Integrity to ensure eligibility files are generated and loaded in a timely manner.

Value Added Services Responsibilities:

• Assists with the execution, accountability and budgetary requirements of the Value Added Services Program which includes conducting research and analysis of current and future Value Added Services when required.
• Ensures all VAS related CRMs are worked by the team within the appropriate timelines.
• Answers VAS related questions from other departments
• Assists with oversight of the VAS program
• Assists with obtaining and negotiating VAS contracts
• Assists with analyzing ROI and utilization data to determine viability of each benefit
• Assists with development of HHSC templates and comparison charts for each LOB
• Assists with researching new VAS benefit opportunities including projecting potential ROI

Education and/or Experience:

• Prefer Bachelor's degree (B. A.) from four-year College or university and minimum of 2-3 years related experience and/or training; or equivalent combination of education and experience.
• Minimum two years in data analytics or reporting
• Prefer one year of Managed Care Experience
• Prefer two years in SQL/database experience
• Strong knowledge of Microsoft Office, including Word, Excel, PowerPoint and Outlook.