Associate Communications Writer

Job Profile Summary

The Associate Writer is an important part of the Medicare Grievances Program, which is the heartbeat of Plan operations and a direct insight to member experience. This role is responsible for drafting, reviewing, or revising member and provider notifications related to member grievances (complaints) to ensure that all complaints are properly investigated and notifications are accurate, complete, and member-friendly.

Job Description

Primary Responsibilities

• Drafts, reviews, and revises resolution letters to members and letters of inquiry to providers and vendors.
• Uses basic understanding of medical terminology and jargon to help identify and write/review potential quality of care concerns a in easy to understand language.
• Rapidly develops and maintains a thorough and up-to-date understanding of organizational functions and processes, client relationships, and Medicare requirements for all aspects of Health Plan Grievances.
• Completes letter review, including reviewing the case and understanding the basis of the member complaint, the investigation the department conducted, any relevant information collected or otherwise available, and the specific resolution for the member.
• Documents deficiencies in draft communications and delivers feedback to respective team members.
• Tracks and trends results of letter review to assist in identifying ongoing training opportunities or specific performance issues.

Qualifications

• Bachelors degree and 1+ year of experience creating content for patients, members, or general public; experience in Medicare Advantage, Appeals & Grievances, and/or other health plan operations (e.g., Claims, Customer Service, Enrollment) can be beneficial
• Firm working knowledge of medical terminology and medical care (i.e. health plan, provider office, or hospital system); preferred experience as a nurse or in delivery of medical care
• Good logical, analytical, critical thinking, investigatory, organizational, decision making and problem-solving skills; ability to remain objective and separate facts from opinions
• Skilled problem-solver with the ability to take on moderately complex problems and achieve a solution within a reasonable amount of time
• Satisfactory time-management skills with the ability to meet deadlines and prioritize work in a fast-paced environment
• Proficient written communication skills and capable of drafting general and specific content for highly technical and complex issues in a form and manner that is easily understood by patients or the general public
• Good interpersonal and customer service skills with the ability to articulate resolutions and communicate contrary facts or potentially upsetting information to the member
• Ability to address administrative requirements or provide education on plan rules or benefit limitations in an understanding and empathetic tone
• Ability to deliver frank and accurate feedback to team member regarding reviewed correspondence

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer: The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands, and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.