Regional Patient Benefits Partner

Job Description

Job Description

Description :

Who is Gather Health?

Gather Health is a collective of outreach partners, care partners, clinicians and, most importantly, patient partners who work together to reshape lives and communities. We bring hands-on social and medical care to our patients and work around their needs, both within our care facilities and in their homes. We work alongside local leaders to build communities and provide tailored care experiences that serve the seniors that live within them. When we Gather, we show love, compassion, community, and care.

What is a “Regional Patient Benefits Partner”?

A Regional Patient Benefits Partner (PBP) ultimately is the direct supervisor of all market PBPs who specialize in benefits of Gather that assists patients with insurance needs, Medicaid applications, and providing solutions to their questions regarding insurance benefits (i.e. Medicare Advantage plans). This person is responsible for ensuring all PBPs are educating patients and prospects about Medicare, Medicaid, and the benefits within it. More importantly, this role directly assists patients by navigating through the process with them. The Regional PBP has a strong knowledge base within the insurance space and is positioned to connect brokers / agents to better service the seniors from a coordinated standpoint. The Regional PBP is reliable, maintains frequent touchpoints with all Gather payor partnerships with the Field Sales Manager and reporting PBPs. This person works strategically with the growth team and clinical operations to help with primary care provider switches (PCP switches), and other duties. The Regional PBP is a people-person with a flourishing personality, outgoing, and disarming to their colleagues, and the senior population. The Regional PBP is also responsible for the production in all aforementioned categories.

What are some of the day-to-day duties?

• Managing all market PBPs at each site
• Ensuring market has a clear defined pathway of plan execution to growth Gather
• Creating clear priorities for PBPs relative the payor landscape to rollout by site for each PBP
• Providing continued education for the growth, and clinical teams of the region
• PCP switches
• Conversion of MA plans
• Managing FMO / Broker Channels
• New Patient Paperwork
• MassHealth Applications
• Assist patients with navigating Medicare and insurance issues which includes coverage, benefits, summaries, eligibility and getting the most out of their plan Serve as internal resource in the clinic on insurance questions for providers and staff.
• Assist patients in navigating the healthcare system, help patients resolve medical bills inside and outside of Gather
• Gain the trust of Gather patients in an effort to properly advise them in their healthcare coverage Manage the welcome visit and orientation process for new Gather Health patients
• Educate patients on how to apply for public benefits, such as Public Aid, and Extra Help for prescription drugs
• Support the medical office management team on operational activities as needed, including scheduling and billing
• Provide exceptional customer service
• Foster patient engagement through the design and execution of events, including office tours
• Leverages patient experience tools to proactively identify members for early service recovery intervention
• Establishes strong relationships with brokers and agents that have ties with center and a strong understanding of our value proposition
• Leverages company tools to enhance patient retention in partnership with practice leadership
• Compliantly connects patients with agents, brokers, and company employees to maintain patient engagement
• Identifies and reports on patient engagement and retention trends to inform strategy in collaboration with practice leadership

So, is this considered a “sales” role?

This is a non – exempt salary role. So when you are educating the prospective patients, and current patients about the Gather Health model and services, you are essentially “selling” our concept of coordinated care under Medicare Advantage products. This is not a “sales” role that involves pitching products or services that the customer doesn’t need or can’t afford. You would be providing them with the opportunity to improve the quality of their lives in a meaningful way. You will also have the opportunity to help maximize their benefits by educating them on what their plans entail. When one truly believes in what they’re “selling” and is passionate about the mission and vision, we believe that it will result in a fulfilling employment experience for them.

How is the pay structured?

The position offers a competitive base salary, plus incentives associated to performance

Requirements :