Health Program Representative I
Elevance Health

Job Info

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Be Part of an Extraordinary Team

Title: Health Program Representative I

Location: Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location: FL-MIAMI, 11430 NW 20TH ST, STE 300 or FL-TAMPA, 5411 SKY CENTER DR

Shift: Remote, Monday - Friday, 9:00am - 5:00pm

Build the Possibilities. Make an Extraordinary Impact.

The Health Program Representative I is responsible for providing initial contact between distinct Care Management programs and specific identified members. Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features.

How you will make an impact:

Primary duties may include, but are not limited to:

• Educate members on the importance of HEDIS related Gaps in Care services.
• Helps with appointment scheduling, transportation, and promotes the incentive program. Addresses redetermination status with caller accordingly.
• 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.

Minimum Requirements:

• Requires HS diploma or the equivalent and a minimum of 6 months experience in a telesales or customer service; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• HEDIS knowledge preferred.
• Computer/keyboarding proficiency strongly preferred.
• Healthcare experience preferred.
• Knowledge of Company products, services and benefits preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

This job has expired.