Health Program Representative

Major Duties and Responsibilities:
• Primary duties may include, but are not limited to: Gathers and records appropriate member information in accordance with policies and procedures via telephone.
• Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services.
• Records call details and utilize call scripts as needed based on client requirements.
• Directs member inquiries to appropriate clinical staff. Initiates referrals and manages consults from clinicians for participants registered in Care Management.
• Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources.
• Contacts physician offices to obtain demographic information or related data as needed.

EDUCATION/EXPERIENCE:
• Requires high school diploma or the equivalent; 6 months experience in a telesales or customer service demonstrating ability to influence customers/ members; or any combination of education/experience, which would provide an equivalent background.
• Computer/keyboarding proficiency and the ability to follow defined policies and protocols required. Knowledge of company products, services and benefits preferred.
• MUST have prior call center experience in a managed care environment.
• 2 years of previous experience in an automated customer service environment;
• High School Diploma, GED, or Equivalent
• General Business Skills Conflict Management

All your information is kept confidential as per EEO standards.

Why is this a great opportunity? The answer is simple…working at our client is more than a job; it’s a career. The opportunities are diverse whether you are right at the start of your career or whether you are looking for new challenges this is the job for you, so be quick and apply now!