Benefits Management Specialists
Neighborhood Health Plan of Rhode Island - Providence, RI

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The Benefits Management Specialist supports the Manager of Configuration Management in the efficient and effective management of member benefit coverage and decisions, and is the key contact for member benefit interpretation and implementation within the organization.


· Bachelor’s degree in a related field or an Associate’s degree and sufficient work experience to equate to a Bachelor’s degree
· 4+ years managed healthcare experience or experience in a related field
· Strong analytical skills
· Experience in clinical settings of care
· Ability to manage multiple projects simultaneously
· Strong computer skills with Windows –based programs, including Outlook, Word, Excel and PowerPoint
· Strong organizational, documentation and interpersonal skills
· Working knowledge of CPT, HCPCS and ICD-9 diagnosis/procedure coding
· Excellent written and oral communication skills
· Project management experience
· Licensed registered nurse ( RN), State of RI
· Certified coder
· MS Project computer skills
· Project management experience
· Master’s degree in a related field
Duties and Responsibilities: Responsibilities include, but are not limited to the following:

Under the direction of the Manager of Configuration Management:
  • Serve as the key contact for member benefits interpretation within the organization, as it relates to all lines of business
  • Manage and coordinate the accurate, efficient and timely implementation of new or revised member benefits for all lines of business, including effective coordination across departments
  • Manage and maintain the internal member benefits portal for use by all Neighborhood staff
  • Facilitate notifications to providers and/or members, staff and web updates
  • Educate and train internal staff as necessary
  • Become familiar with claims processing system and maintain a basic understanding of system configuration in order to facilitate member benefit coverage alignment within system
  • Collaborate with key stakeholders to capture project tasks, milestones, and deliverable dates
  • Perform research and draft summaries related to member benefits projects
  • Ensure all project related activities are compliant with Neighborhood policies and procedures regarding data collection, data exchange and release of information external to the organization
  • Special projects as requested

Neighborhood is an M/F/D/V and an E-Verify Employer.

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The overall health of the people of Rhode Island is overseen by the Rhode Island Department of Health, which is overseen by a...