Manager of Client Services - Government Programs

Job Description

Job Description

Description : Overview

We are seeking a knowledgeable and compassionate professional with expertise in Medicare, Medicaid, and other federal and state health programs to serve as a key point of contact for our members and clients. This role is dedicated to ensuring members have the support they need to navigate coverage, benefits, and prior authorization processes, while also partnering with clients to deliver exceptional service.

Responsibilities

• Serve as the primary point of contact for members and clients regarding Medicare, Medicaid, Marketplace, and other federal or state program benefits.
• Provide guidance and education to members on coverage, eligibility, enrollment, and appeals processes.
• Assist members with navigating prior authorizations, claims, and billing issues, ensuring timely resolution and clear communication.
• Collaborate with providers, pharmacies, and internal teams to address and resolve complex benefit and coverage questions.
• Monitor changes in federal and state program regulations to ensure compliance and keep stakeholders informed.
• Develop and maintain strong relationships with clients, ensuring a high level of satisfaction and trust.
• Track and analyze member issues to identify trends and recommend process improvements.

Requirements : Qualifications

Preferred Skills