Membership Associate
AI Summary
The Membership Associate processes and maintains documentation for provider participation and health plan enrollment, updating CRM data and managing membership rosters. They handle provider life cycle, stakeholder communication, and process optimization.
About this role
Primary Duties
Provider Life Cycle Management
Submit and monitor practice and physician applications and terminations; follow up as needed.
Collaborate with practice coaches to obtain accurate data for enrollment.
Compile and maintain current and accurate data for all providers in databases and online systems.
Maintain strict confidentiality of sensitive physician information and membership documentation.
Practice and Stakeholder Communication
Communicate with practices on a regular basis for physician updates, information requests, and general upkeep.
Communicate with health plan representatives on outstanding issues.
Collaborate with Market Operations Managers and Operations Consultants to reconcile physician lists and administrative payments.
Process Optimization and Strategy
Work alongside the membership team and Operations Manager to streamline and optimize current processes.
Attend mandatory and routine meetings as required
Administration and Ad Hoc Projects
Perform other duties as assigned.
Maintain flexibility to pivot and meet shifting or dynamic business needs.
Minimum Qualifications
• High School Diploma required.
• Proficient in Microsoft Word, Excel, Outlook, and PowerPoint.
• Excellent time management, project management, organizational and communication (written and verbal) skills.
• Ability to work independently and proactively to identify and complete tasks on-time. Capable of prioritizing work and managing multiple priorities.
• Ability to interact effectively with external and internal customers and possess a professional business manner.
• Must be a team player and operate in a collaborative working environment.
• Adept with computers and software applications; aptitude for learning new technology.
Preferred knowledge, skills, and/or abilities
• Associates Degree in Business Administration or Healthcare Administration preferred, or equivalent combination of education and experience.
• 2+ years in a healthcare-related administrative assistant or coordinator position preferred.
• Knowledge and understanding of the credentialing process preferred
•Experience with health plan payer portals preferred
• Familiarity with Monday.com, Salesforce, and AI tools
