Tribal Benefits Manager (37106)

AGUA CALIENTE BAND OF CAHUILLA INDIANS•Palm Springs, CA

1d•Onsite

About The Position

The Tribal Benefits Manager provides dedicated administrative and advocacy support to ensure Tribal Members fully understand and utilize their health and group benefits. This specialized role focuses entirely on serving the unique health and benefit needs of Tribal Membership.

Requirements

Minimum of 5 years of experience in benefits administration, healthcare advocacy, or patient navigation.
Proficiency with basic database management, benefits enrollment software, and Microsoft Office Suite (Word, Excel, Outlook).
Strong analytical skills with the ability to make independent decisions and take action based on leadership direction, established guidelines, and sound judgment.
Proven ability to communicate effectively in both verbal and written forms with all levels of management, Tribal Members, employees, and external visitors.
Detail-oriented mindset with the ability to organize/prioritize heavy workloads, meet strict deadlines, and maintain focus with minimal supervision amidst multiple interruptions.
Must be able to stand, move, and work throughout office and enterprise properties, including walking up to 1.5 miles and climbing stairs or step stools.
Must have sufficient hand dexterity to operate standard office equipment (computer keyboards, calculators, and multi-line telephone systems).
Must be able to grasp, bend, lift, and carry office goods weighing up to 30 lbs. on an intermittent basis.

Nice To Haves

Bachelor’s degree in Business, Healthcare Administration, Human Services, or a related field preferred.
Previous experience working within a Tribal organization or direct familiarity with Indian Health Service (IHS) and Purchased/Referred Care (PRC/CHS) is highly preferred.

Responsibilities

Guide Tribal Members through the complete enrollment process for health and group benefits programs.
Manage all aspects of record-keeping, auditing, and compliance associated with membership benefit plans.
Communicate directly with insurance providers, carrier representatives, and third-party administrators to ensure accurate updates, changes, and record management.
Act as the primary, accessible point of contact to answer questions regarding plan coverage, co-pays, and provider networks.
Assist members in navigating, investigating, and resolving complex medical, dental, or vision claim disputes and billing errors.
Review, verify, and submit member Flexible Spending Account (FSA) and other claim reimbursement documentation.
Process specialized Tribal Membership benefit requests, including caregiver payments and durable medical equipment (DME) requests.
Collect, organize, and track specific data pipelines to support medical claim review and the Tribal MLR program.
Create and publish membership communications, including flyers and memoranda.
Protect member privacy by handling all Protected Health Information (PHI) and personal documentation with strict confidentiality and HIPAA compliance.
Deliver all services with deep respect for Tribal traditions, community dynamics, and cultural values.