Location: Washington, DC-Hybrid opportunity-1-2 days minimum in office per week
Schedule: Monday-Friday 8:00AM to 5:00PM EST or 8:30AM to 5:00PM EST
Responsible for serving as the initial and main point of Field contact between the Company and the current and potential members for DC Medicaid Clinical arena.
How you will make an impact:
- Responds to telephone, written, and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures.
- Researches and resolves complex customer and business issues.
- Provides timely and accurate resolution of inquiries and issues regarding benefits, services and policies.
- Supports and promotes State Sponsored Programs through participation in community events.
- Represents State Sponsored Programs in community collaborations.
- Supports member access to care through home visits, processing of reports, and distribution of collateral materials.
- Performs new member orientations.
- Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up.
- Participates in promotional activities.
- Provides superior, professional, and courteous service to customers.
- Organizes daily work without significant guidance.
- Collaborates with team members to provide superior customer services.
- Supports Health Management Programs.
- Conducts research to assist customers with inquiries or issues.
- Actively identifies and pursues opportunities for team involvement.
- Trains CRC associates. Provides leadership in the development and implementation of the Outreach Program and work plans.
- Comprehends the various cultural and linguistic needs of the Medicaid and SCHIP population, knowledge of the various health and social services available in the assigned region with a special emphasis on services offered by community-based organizations, ability to work professionally with the company's associates, community-based organizations, providers and plan members.
- Represents department with key internal and external stake holders and targeted community partners.
- Mentors and coaches Outreach staff.
- Generates management reports.
- Re-engages enrollee by discussing the range of available services, and the potential benefits of participation.
- Provides telephonic, written, and face to face outreach and orientation services.
- Responds to prospective enrollee and referral sources (such as services providers) questions.
- Travel to our Washington, DC office minimum one to two times per week.
Requires a HS Diploma a minimum of 4 years of customer service experience; or any combination of education and experience which would provide an equivalent background. For Medicaid business units, a Community Health Worker Certification is required.
Preferred Skills, Capabilities and Experiences:
- Understanding of the basic principles of managed care and the concepts of publicly financed health insurance such as Medicaid and SCHIP programs strongly preferred
- Experience in Case Management and/or care coordination
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
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 – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 firstname.lastname@example.org for assistance.