Case Manager

Department of Health and Human Services • Portland, OR

9d • Hybrid

About The Position

OHIM seeks a Case Manager that will support the operations team in case management work. The position will perform casework that is escalated, primarily from the Consumer Assistance Center. This position will also play a supporting role in user acceptance testing of the changes to the eligibility and enrollment platform. The position will monitor the service provided, evaluating the data that comes from client interactions, to aid in planning and policy development. This position will report directly to the Consumer Experience Manager.

Requirements

• A Bachelor’s Degree in Public/Community Health, Health Administration, Health Sciences, Social Sciences, Health Education, Public Administration, Government, Social Work, or a related field and three (3) years professional experience in the planning, development, coordination and/or evaluation of health programs or services -OR- an equivalent seven (7) year combination of education, training, and experience.
• Knowledge of healthcare coverage programs (e.g., private insurance, MaineCare or Medicare).
• Strong verbal and written communication skills.
• Ability to use independent judgment, initiative, and discretion to problem solve and make determinations on varied matters.
• Ability in providing kind, courteous, and exceptional customer service.

Responsibilities

• Monitor non-routine consumer related work regarding eligibility and enrollment.
• Utilize the internal policy manual to recommend decisions, when relevant
• Provide casework support for escalated cases from brokers and Maine Enrollment Assisters (MEAs).
• Provide results and feedback to broker and navigator program coordinator so she can communicate findings and recommendations to brokers, MEAs and navigators.
• Discuss health insurance issues with appropriate senior manager in order to ensure the accuracy and credibility of insurance enrollments
• Organize and write plans, decision documentation, and other documents in order to provide information.
• Present and explain reports to various groups in order to increase understanding and achieve support for conclusions
• Assist in identifying areas of opportunity for consumer and stakeholder education based on frequent types of escalated cases. Communicate these opportunities to consumer communication team.
• Assist in User Acceptance Testing (UAT) for defects, system enhancements, features, and functionality
• Other duties as assigned.

Benefits

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave , and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
• Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($12,845.82 - $15,112.76 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.
• Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements .
• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($395.72 annual value).
• Retirement Plan – The State contributes the equivalent of 14.11% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).
• Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave . Additional, unpaid leave may also be available, under the Family and Medical Leave Act .
• State employees are eligible for an extensive and highly competitive benefits package , covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness .

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees