Personal Care Connector (Remote) Charleston, SC Area Only

Your career starts now. We are looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Responsibilities:

The Personal Care Connector (PCC) is a high-touch, highly effective service specialist responsible for supporting the daily operations of Medicare Member Services (Personal Service Program), integrated care management, and utilization management program interventions. The PCC performs in a contact center environment, effectively handling calls from members, providers, and other internal and external areas of the company. The PCC handles daily routine calls from Members & Providers by metric and performance requirements, identifies members with Care Gaps/HEDIS-related health conditions, and assists them in accessing care through Plan benefits and community resources. The PCC will handle all in/outbound calls and transactions directly, supporting Clinical staff and assigned local teams, providing members with problem resolutions and educational materials, and carrying out strategies to increase healthcare adherence to reduce barriers to care.

Education & Experience:

• 3 to 5 years experience in a call center and the ability to effectively handle inbound/outbound calls for triage and resolution.

• 2 to 4 years working knowledge of Medicare & Medicaid preferred.

• High School/GED required.

• Experience in healthcare preferred.

• Proficient PC skills with Microsoft Suite (Word, Excel, etc.) and the ability to utilize and navigate multiple systems simultaneously.

• Working knowledge of Plan Benefits and Services is preferred.

• Effective oral and written communication and the ability

• Ability to document case notes while speaking on the phone with customers

• Thoroughly and efficiently gather customer information, assess and fulfill customer needs, and educate customers where applicable regarding products and services listed above.

• Ability to handle multiple tasks simultaneously

• Act as interface and facilitator between members and provider offices

• Professionally handle incoming inquiries from customers regarding benefit eligibility or customer issues.

• Effective outbound call skills to deliver educational messages, collect health data, and critical thinking required to assess, triage, and offer solutions.

• Be dependable and meet all attendance requirements.

• Meet or exceed company performance metrics, including phone availability, occupancy, attendance, call handling quality, call documentation and routing on all calls handled, and adhering to all Regulatory Compliance requirements.

• Ability to provide solutions to customers while maintaining compliance and service objectives

• Remote position: The ideal candidate must be located in and around Charleston, South Carolina.

• Shift will be from 11:30 am to 8:00 pm Eastern Standard Time (EST)

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.