Health Program Representative II
1 week ago
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:
- 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 utilizes 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.
- 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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