Remote Member Services Advocate Jobs

Strong time management skills required. Must be able to prioritize and adhere to competing deadlines.

2+ years healthcare experience or educational equivalent

Expert/Highly Skilled with computer skills: Windows-based applications and Microsoft applications

Advanced organizational and communication skills

Four-year advanced degree or equivalent work experience in healthcare payors, social services field, advocacy, customer relations, or other related industry

Skill in establishing priorities with independent coordination of day-to-day duties

Minimum 1 year work experience.

Great communication and problem solving skills

Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Advancement opportunities, professional skills training, and tuition Reimbursement

Handle various communication channels with providers, including inbound and outbound provider calls which involve researching, resolving, and documenting issues.

Analyze data and determines if CareCentrix claims processing guidelines have been followed correctly by researching plan, eligibility, and patient authorization information.

Assists in project management of the social needs and health equity initiatives

Support organizational DEI change readiness and management efforts

Plans, coordinates and reports on health promotion and wellness education outreach activities for the UnitedHealthcare Community and State plan in Tennessee

Participates in continued education in social responsibility, social determinants, and all other necessary education

Bachelors degree in healthcare, public health, social work, or similar field or equivalent experience in health care or social work

4+ years of experience in a deadline driven environment

Some knowledge of healthcare and/or insurance benefits preferred.

Give feedback to the product team about member support issues so they can design better experiences.

Bachelor’s degree with 2 years of related experience in social work, patient advocacy, or health coaching preferred.

Help new customers with their onboarding, making sure members understand and select appropriate health plans and other steps.

Generally strive to make sure members feel taken care of and love our service.

Strong preference for candidates fluent in Spanish and English.

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner.

Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.

Effective communication skills in a professionally setting, both spoken and verbal.

Manages multiple channels of communication (e.g., Teams, Jabber) within a timely manner.

Must be available to work between operation hours of 5:00am-8:00pm PST.

Bachelor's degree in Accounting, Finance, Healthcare Administration, or a related field

1-3 years of job-related experience

Strong statistical and analytical skills – proficient in Excel

Effective oral and written communication skills

Credentialed in appropriate EPIC application(s) within 90 days of hire

1-2 years advanced Financial Analysis

Four (4) years of administrative and/or customer service experience or equivalent combination of education and experience required.

Assist members with day-to-day benefits and healthcare-related questions and/or issues

Conduct member contacts related to benefit support, referral follow-up, and resource inquiries

Experience working in a Call Center Environment required

One (1) year of experience working in the Health Care industry required

Excellent oral and written communication skills

Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.

Apply strong knowledge of HIPAA regulations

Experience in delivering client-focused solutions based on customer needs

Experience in billing, insurance, healthcare or legal environments a plus

Excellent written and verbal communication skills

Multiple Health Plan Options, including a 100% Employer Paid Benefit Options

Experience with Vendor Management Systems, Digital Marketing, E-Commerce, and Merchandising

15% - Tracks content performance, digital asset management, assortment opportunities via regular reporting.

Major Tasks, Responsibilities And Key Accountabilities

10% - Offers industry expertise and acts as the subject matter expert for the supported assortment/category.

5% - Builds system knowledge and expertise through ongoing tailored, training classes.

Experience with SQL, Tableau and Adobe products

Experience with Vendor Management Systems, Digital Marketing, E-Commerce, and Merchandising.

10% System Knowledge - Builds system knowledge and expertise through ongoing tailored, training classes.

This Position typically reports to Manager, Brand Advocate

Experience with SQL, Tableau and Adobe products.

Manages multiple projects with competing priorities.

Strong written and oral communication skills.

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Dynamic leadership for Contact Center management team and agents.

Sets a positive example for others and builds our Molina culture by modeling our vision and values in their daily actions.

Strong leader, ability to develop teams focused on delivering great healthcare service to a population that has often been underserved.

Meets and exceeds department KPI's including productivity and service quality goals. Implements strategies to meet/exceed goals.

Drives process improvements to ensure performance standard goals including quality goals are met

Become proficient in learning the Aerial program to review information re: Case Management

Attends weekly Health Partners meeting with Benefit Team at Whirlpool, Account Managers and Health Coaches

Demonstrated team leadership experience and/or skills

Clinical experience and/ or a Managed Care background

Knowledge of medical claims administration and employee benefit plans

Attend meetings with account manager, client, vendors, and other healthcare team members as needed

Experience working with and documenting via CRM or other tracking method. Effective verbal and written communication skills.

Manage internal processes that may be manual in nature while thinking strategically toward a smarter method…incorporating opportunities for efficiency/automation whenever possible.

Associate degree, or high school diploma with 5-7 years related experience. Bachelor’s degree preferred.

Effective interpersonal skills with a service minded team attitude.

Maintain partner profiles, contact lists, distribution addresses and other methods of contact which affect client connections.

Be flexible to adjust duties as needed to coordinate with business needs and industry trends.

Conducts member health coaching and provides treatment decision support service via printed educational materials and videos

5 years recent experience in the acute care setting preferred

Excellent written and verbal communication skills

Outstanding team player & strong interpersonal skills

Strong organizational skills and the ability to multitask with ease

Serve as the ongoing coordinator of primary and preventative care, episodic care, expert medical opinion and other service lines

Applicants must meet all the qualification requirements described below by the closing date of this announcement.

There is no substitute of education for specialized experience for the GS-12 position.

Education requirements do not apply to this vacancy announcement.

Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit: www.dhs.gov/E-Verify/

Experience analyzing regulations on victims’ rights to obtain restitution, representation and other eligibilities for witnesses of crime.

Experience synthesizing priorities and resource needs for victims to respond to barriers to participation in the judicial process.

Experience analyzing regulations on victims’ rights to obtain restitution, representation and other eligibilities for witnesses of crime.

Experience synthesizing priorities and resource needs for victims to respond to barriers to participation in the judicial process.

Experience serving as a first responder to victims to provide advocacy to those experiencing manifestations of trauma as symptoms of victimization.

Experience providing training through oral communication to effectively reconcile victims’ needs and express victim-centric approaches to witness interactions.

Knowledge of existing national and international resources pertaining to victim's advocacy.

Ability to assess needs following trauma experiences.

Manage and process incoming referrals with speed and accuracy within required deadlines

Understand and comprehend different partner requirements & protocols, as well as be able to determine that documentation is within compliance

Excellent verbal and basic writing skills

Maintain a high level of communication both internally and externally

Verify and/or request client eligibility and/or authorizations from partner agencies

Troubleshoot, audit, update, and retrieve data, within a specified timeline as required by contract

Strong decision making and time management skills with the ability to manage multiple projects/duties.

Essential Skills, Knowledge and Requirements

Provides input to management on workflow issues, patterns and improvements.

Hourly Wage: $18.60 to $21.00. Individual wage will vary based on skills and experience.

High School Diploma or equivalent; college degree preferred; will consider experience in lieu of degree.

Minimum of two years’ experience in financial services industry, preferably in a call center.

Knowledge of a variety of computer software applications along with excellent data entry skills.

Two (2) to four (4) years of customer service experience required.

Must be customer focused and possess excellent customer service and telephonic skills with demonstrated poise, tact, and diplomacy.

High level of interpersonal skills to handle sensitive and confidential situations.

Answers patient inquiries by clarifying desired information; researching, locating, and providing information.

Schedules patient appointments based on client-specific services.

What We Can Offer YOU!

IMPORTANT FOR YOU TO KNOW:

What You Will Be Doing:

What We Prefer You To Have: