Field Support Specialist - Las Vegas, NA & Salt Lake City, UT - 28313

TriWest Healthcare Alliance • North Las Vegas, NV

393d • $66,000 - $73,000 • Onsite

About The Position

The Field Support Specialist position at TriWest Healthcare Alliance is designed to support military treatment facilities (MTFs) by providing non-clinical assistance to TRICARE beneficiaries. The role involves working closely with MTF staff to facilitate patient referrals, authorizations, and outreach to network providers, ensuring effective communication and resolution of issues. The incumbent will also conduct educational briefings and assist in contingency planning for MTF exercises. This position requires travel to various MTFs and regional hubs, reporting directly to the MVS Regional Director.

Requirements

• High School Diploma or GED.
• US Citizenship.
• Ability to receive a favorable Interim and adjudicated final DoD background investigation.
• 2+ years of experience with the TRICARE Program in customer service and administrative support to clinical operations.
• Demonstrated success in a highly matrixed organizational environment.

Nice To Haves

• Bachelor's Degree in health-related studies (Health Administration, Health Policy, Public Health, Public Administration, or Communications).
• Experience as a TRICARE Beneficiary Counseling and Assistance Coordinator (BCAC).
• Experience in MTF TRICARE business operations.

Responsibilities

• Develop and maintain an understanding of TriWest's responsibilities and performance requirements related to MTF support.
• Serve as the designated point of contact for MTF staff regarding enrollment, referrals, authorizations, and network provider issues.
• Utilize the TriWest CRM to refer identified issues to the appropriate corporate division for resolution.
• Monitor referred issues for trends and opportunities to improve services, keeping the Regional Director informed.
• Review and facilitate resolution of referral and authorization issues, analyzing root causes and implementing corrective strategies.
• Provide TRICARE information and educational briefings to MTF staff, providers, and beneficiary groups.
• Conduct outreach activities for military community groups and provide educational briefings on TRICARE enrollment and services.
• Document performance of educational briefings for contract performance reporting.
• Collaborate with MTF staff to identify opportunities for optimization in support of DHA Network goals.
• Assist with contingency planning for MTF exercises or actual scenarios as needed.
• Maintain knowledge of the Managed Care Support Contract and TriWest policies and procedures.
• Ensure proficiency in using the CRM system for customer service transactions and issue reporting.
• Input potential quality of care or safety issues into the CRM and report them accordingly.
• Meet productivity and performance metrics as determined by TriWest and MVS policies.
• Perform other duties as assigned.

Benefits

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability insurance
• Basic life and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED