Working Each Day to Make a Difference

At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.

More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.

We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.

• We are a local not-for-profit health plan in Washington State.
• We are committed to keeping Washington families healthy.
• We connect our communities to the health resources they need.
• We provide access to high-quality care for our members.
• We connect and empower our members through technology.
• The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
• Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.

To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.

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Eligibility Coordinator -- Hybrid, WA

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[POSITION PURPOSE:]{.underline}

Is responsible for overall coordination of the Washington Apple Health eligibility/enrollment process, including data verification, error correction, updates, disenrollment, and enrollment tracking, and for understanding and administering the contract requirements for each product.

[PRINCIPAL DUTIES:]{.underline}

• Research and correct enrollment errors
• Processes Primary Care Provider (PCP) change requests
• Resolves eligibility, ID card, pharmacy access, issues and concerns raised by the plan, clinics, TPA, state or member
• Communicates orally and in writing with state, other departments, and members when necessary
• Sends letters to members with terming PCPs and/or Specialist
• Participates as a subject matter expert for business process improvements or system implementations when called upon
• Non-Exempt - Reporting to work on time and for all scheduled shifts is essential to this position.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

[QUALIFICATIONS:]{.underline}

[Education &]{.underline} [Prior Related Experience]{.underline}:

•  Possess a High School Diploma or any combination of academic education, professional training, or work experience, which demonstrates the ability to perform the duties of the position
• Have a minimum of (2) years operational experience in a managed health care environment
• Have a minimum of (2) years involvement with eligibility processes and procedures
• Have knowledge of medical terminology and coursework (strongly preferred)
• Have experience with State Medicaid Programs
• Are proficient in Microsoft Word, Excel, and Outlook

[Employment Eligibility:]{.underline}

• Candidate has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.* *

[Knowledge, Skills, and Abilities]{.underline}:

Ability to meet deadlines as established by state and federal regulations, NCQA, contractual obligations and Plan policies

Strong written and verbal communication skills; able to communicate w