Healthcare Management Specialist

General Description

The Healthcare Management Specialist will work under the direct supervision of the Assistant Director of Human Resources: Benefits. The incumbent will provide support to employees and retirees enrolled in Research Foundation health and wellness plans. The incumbent will assist members to navigate the complexities of coverage, provide education and training, and integrate the support services that the member needs to optimize the healthcare and psychosocial goals and outcomes. The Healthcare Management Specialist will ensure compliance with regulations including HIPAA, standards and best practices, and communicate with stakeholders including staff and vendors. identifying and resolving problems and issues as well as leading and facilitating change and improvement initiatives.

Other Duties

• Assist enrolled members with navigating health insurance, Medicare, and legal processes, provide the members with financial advice and resources
• Invoice and process retiree Medicare reimbursements
• Advocate for members and assist them in navigating complex healthcare systems
• Educate members on their conditions and provide them with self-management tools and resources to alleviate discomfort and stress
• Establish strong communication and build meaningful relationships with individual patients
• Coordinate wellness events for RFCUNY employees at Central Office and across all CUNY locations including onsite vaccinations and screenings
• Facilitate care coordination across multiple providers, specialists, and healthcare networks
• Collaborate with insurance carrier and EAP/ health advocacy provider as necessary to resolve coordination of benefits, claims, and/or billing issues efficiently
• Lead wellness presentations, information sessions, webinars, and present at annual open enrollment events
• Monitor trends and maintain relevant metrics
• Other duties as assigned

Qualifications

• Minimum BS, BA, BSW, or BSN Degree in Healthcare, Human Services, Social Work, Allied Health, Case Management or related preferred
• Minimum 4 years' experience working in healthcare, employee assistance program, patient care, or insurance preferred
• Ability to organize and analyze facts, and to draw logical conclusions
• Leadership and teamwork skills
• Ability to multitask and meet short deadlines required
• Excellent public speaking and written communication skills
• Occasional travel to multiple locations

RFCUNY Benefits
RFCUNY Employee Benefits and Accruals

About the Research Foundation

The Research Foundation of The City University of New York (RFCUNY) was established as a not-for-profit educational corporation chartered by the State of New York in 1963. RFCUNY supports CUNY faculty and staff in identifying and obtaining external support (pre-award) from government and private sponsors and is responsible for the administration of all such funded programs (post-award).

RFCUNY stands between CUNY's principal investigators (PIs) and the sponsors who support them and strives to fulfill its essential responsibilities to both groups. Working closely with individual PIs and Grants Officers on the campuses, RFCUNY oversees employment, accounting, audit, reporting, purchasing, and special responsibilities that include management of a planned giving program; liaison with governmental agencies and foundations; negotiation of agreements; facility construction and renovation; protection and commercialization of intellectual property; and compliance with applicable standards in research involving human subjects, animal care, environmental and radiological safety, and conflicts of interest.

Equal Employment Opportunity Statement
The Research Foundation of the City University of New York is an Equal Opportunity/Affirmative Action/Americans with Disabilities Act/E-Verify Employer. It is the policy of the Research Foundation of CUNY to provide equal employment opportunities free of discrimination based on race, color, age, religion, sex, pregnancy, childbirth, national origin, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, marital status, domestic violence victim status, arrest record, criminal conviction history, or any other protected characteristic under applicable law.