Healthcare - Membership Representative II

Saviance


Date: 2 weeks ago
City: Union City, CA
Contract type: Full time
Job Description: 100 % remote- Must work in PST.

Are there time zone requirements that the resource(s) must work within (i.e., must work PST hours)? Work hours will be in PST shifts

What is the typical schedule/shift going to be (i.e., 8am 5pm)? 8:00 am 5:00 pm PST

We need some bilingual candidates that can speak- Spanish, Vietnamese, Chinese, Korean

Temps will need Laptop, mouse, keyboard, headset, 1 monitor

" Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD and DSNP plans. Serves as an advocate to ensure members are well informed about plan benefits, provider options and how to use their new plan benefits.

" Serve as the member s navigator during the onboarding process and address any plan questions and anticipate any issues that may arise. Determine the nature of the member's needs and interests; inform members of their plan resources and benefits with a focus on the member s area of interest/needs; and follow up with member to ensure needs are met and member is having a positive plan experience. Develop relationship with member to be the go-to person with any future issues or questions.

" Log all interactions in required systems.

" Participates in regular member benefits training with health plan, including the member advocate/engagement role.

Must Have Skills

" Medicare/Medicaid background is strongly preferred

" Candidates must be able to navigate multiple systems

" Customer services / consumer advocacy skills

" Experience conducting intake, interviews, and/or research of consumer or provider issues.

" Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager.

" Basic understanding of managed healthcare systems and Medicare.

Day To Day Responsibilities

Required Years of Experience: 2 years experience in customer service, consumer advocacy, and/or health care systems.

Required Licensure / Education: High School diploma.

Comments for Suppliers: Retention calls to CHP/BND members

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