Health Program Representative II

1 week ago


Manila, National Capital Region, Philippines Private Advertiser Full time

Responsible for providing initial contact between distinct Care Management programs and specific identified members. Under general supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features.

Primary duties may include, but are not limited to:

  1. Gathers and records appropriate member information in accordance with policies and procedures via telephone.
  2. Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services.
  3. Records call details and utilizes call scripts as needed based on client requirements.
  4. Directs member inquiries to appropriate clinical staff.
  5. Initiates referrals and manages consults from clinicians for participants registered in Care Management.
  6. 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.
  7. Mentors less experienced Health Program Advocates.

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

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