Coordinator Concierge Service

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Your career starts now. We are looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare 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 want 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.

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Responsibilities:

Reporting to the Manager of Medicare VIP Services, the Concierge Service Coordinator (CSC) is a highly motivated, extremely effective specialist responsible for providing targeted, personalized concierge-level service for AmeriHealth Caritas members. The CSC's job is to engage, consult, and educate members based on unique needs, preferences, and understanding of the AmeriHealth Caritas plan to help guide the member to quality and timely care. Support Medical Management, Member Services, Quality Team, and others as appropriate.

The CSC will be assigned to a group of members identified by the plan to establish relationships based on a holistic view to ensure a trusted relationship with the member occurs. The Coordinator will ensure that timely introduction to the plan materializes, maintain monthly contact with high-risk members, contact identified members with Care Gaps/HEDIS-related health conditions, and assist them in accessing care through plan benefits and community resources. The Coordinator will directly handle all inbound/outbound calls and transactions, supporting assigned groups with problem-resolution educational materials while developing strategies to increase healthcare adherence to reduce barriers to care. Additional duties include:

• Manage the customer relationship by providing customized interaction based on member needs, creating a connection to ensure retention and maintain member loyalty.
• Provide member education and counseling on access to services, benefits, and providers.
• Resolve member concerns, providing resolution within expected or required timeframes.
• Complete welcome calls for the members newly enrolled with the plan, including scheduling initial assessment for Medical Management as required by contract.
• Research members that are hard to locate using various methods and search engines.
• Maintain a working knowledge of Plan Benefits and Services.
• F/U assistance for Quality of Care Grievances to ensure member satisfaction.
• Responsible for record-keeping, documenting call dispositions, and compiling and generating reports as required.
• Assume ownership and responsibility for member satisfaction with AmeriHealth Caritas during the member's first year of enrollment into the plan and remove barriers to care.
• Address member concerns, fully assist, and answer questions related to member and provider resources, benefits, enrollment, HEDIS preventative services, member bills, LTSS services, and other questions that may arise during their one year with the plan and while included in a particular member group.
• Ability to identify member needs beyond the initial inquiry, including the ability to provide solutions to concerns regarding food resources, shelter resources, additional plan details, etc
• Collaborates with colleagues to deliver a VIP Experience for members.
• Identify trends and emerging customer service issues that might impact member satisfaction.
• Assist with Redetermination Applications when appropriate to avoid service disruption.

Education & Experience:

• Associate's Degree preferred or equivalent work experience.
• A valid health insurance license is required or must be successfully obtained within six months of the start date.
• Two years of customer service in a healthcare/clinical/hospital setting or human service experience.
• Two years of working knowledge of Medicare/Medicaid.
• Proficient PC skills with Microsoft Office Suite (Word, Excel, etc.)
• Excellent problem-solving and organization skills.
• Ability to work independently or as a team.
• Ability to navigate through multiple software systems simultaneously.
• Strong interpersonal communication skills.
• Ability to maintain positive relationships with both internal and external customers.
• Ability to work before/past regular shift hours to complete any outstanding task(s) for members.
• Attention to detail and accuracy.
• Attend Medicare community events.
• Must be able to lift up to 25 pounds.

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 include 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 one, 401(k), tuition reimbursement, and more.