AmeriHealth Caritas

Remote Personal Care Connector (Southfield, Michigan areas only)


PayCompetitive
LocationSouthfield/Michigan
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: 29327

      Your career starts now. We’re looking for the next generation of health care leaders.

      At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care 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’d like to hear from 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.

      Responsibilities:

      The Personal Care Connector (PCC) is a high-touch, extremely 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 areas, internal and external to the company. The PCC handles daily routine calls from Members & Providers in accordance with 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, provide members with problem resolutions, educational materials, and carry out strategies to increase health care adherence to reduce barriers to care.

      Education & Experience:

      • 3 to 5 years’ experience in a call center experience and to effective handle in-bound/out-bound 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: availability on phone, 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

      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.

      Our Comprehensive Benefits Package

      Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

  • About the company

      AmeriHealth Caritas is a different kind of health care company. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP — plus pharmacy benefit management, behavioral health, and administrative services.