Tribal Benefits Manager (37106)

Come work for the leading employer in the Coachella Valley. Agua Caliente offers a comprehensive benefit and compensation package that includes rich medical and dental benefits, a 401k plan with employer match, more than 3 weeks of paid time off per year for newly hired employees, and other great benefits like food and beverage discounts at our three casinos, fuel discounts, tuition and wellness reimbursement, plus much, more.  

JOB DESCRIPTION SUMMARY

The Tribal Benefits Manager provides dedicated administrative and advocacy support to ensure Tribal Members fully understand and utilize their health and group benefits. This specialized role focuses entirely on serving the unique health and benefit needs of Tribal Membership.

ESSENTIAL DUTIES AND RESPONSIBILITIES (other duties may be assigned)

• Guide Tribal Members through the complete enrollment process for health and group benefits programs.
• Manage all aspects of record-keeping, auditing, and compliance associated with membership benefit plans.
• Communicate directly with insurance providers, carrier representatives, and third-party administrators to ensure accurate updates, changes, and record management.
• Act as the primary, accessible point of contact to answer questions regarding plan coverage, co-pays, and provider networks.
• Assist members in navigating, investigating, and resolving complex medical, dental, or vision claim disputes and billing errors.
• Review, verify, and submit member Flexible Spending Account (FSA) and other claim reimbursement documentation.
• Process specialized Tribal Membership benefit requests, including caregiver payments and durable medical equipment (DME) requests.
• Collect, organize, and track specific data pipelines to support medical claim review and the Tribal MLR program.
• Create and publish membership communications, including flyers and memoranda.
• Protect member privacy by handling all Protected Health Information (PHI) and personal documentation with strict confidentiality and HIPAA compliance.
• Deliver all services with deep respect for Tribal traditions, community dynamics, and cultural values

SUPERVISORY RESPONSIBILITIES

None

ACCESS TO SENSITIVE AREAS AND INFORMATION

Full access to highly confidential materials, including Protected Health Information (PHI) and Tribal Member personally identifiable information (PII).

SIGNATORY ABILITY

Authorized to sign benefit-related forms and documents.

EDUCATION and/or EXPERIENCE

• Minimum of 5 years of experience in benefits administration, healthcare advocacy, or patient navigation.
•  Bachelor’s degree in Business, Healthcare Administration, Human Services, or a related field preferred.
• Previous experience working within a Tribal organization or direct familiarity with Indian Health Service (IHS) and Purchased/Referred Care (PRC/CHS) is highly preferred.
• Proficiency with basic database management, benefits enrollment software, and Microsoft Office Suite (Word, Excel, Outlook).
• Strong analytical skills with the ability to make independent decisions and take action based on leadership direction, established guidelines, and sound judgment.
• Proven ability to communicate effectively in both verbal and written forms with all levels of management, Tribal Members, employees, and external visitors.
• Detail-oriented mindset with the ability to organize/prioritize heavy workloads, meet strict deadlines, and maintain focus with minimal supervision amidst multiple interruptions.

Physical Requirements & Work Environment

• Must be able to stand, move, and work throughout office and enterprise properties, including walking up to 1.5 miles and climbing stairs or step stools.
• Must have sufficient hand dexterity to operate standard office equipment (computer keyboards, calculators, and multi-line telephone systems).
• Must be able to grasp, bend, lift, and carry office goods weighing up to 30 lbs. on an intermittent basis.
• Primarily housed in a standard climate-controlled office environment. The noise level is typically moderate but may escalate to loud when visiting or crossing casino floor environments.