Health Program Representative I

About the role

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Responsibilities

• 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 utilize 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.
• Maintains focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
• Communicates effectively with virtual and in-person interactions, demonstrating empathy and persistence to resolve caller issues completely.
• Uses digital tools and platforms to enhance productivity and minimize manual efforts.

Requirements

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

Preferred Skills, Capabilities, And Experiences

• Computer/keyboarding proficiency strongly preferred.
• Knowledge of company products, services and benefits preferred.

Benefits

• A career path with opportunity for growth.
• Ability to obtain your Associate’s or Bachelor’s degree or further your education with tuition reimbursement.
• Affordable Health Insurance, Dental, Vision and Basic Life.
• 401K match, Paid Time Off, Holiday Pay.
• Annual incentive bonus and annual increases plan based on performance.

Pay

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

Schedule

Monday - Friday, 8 AM - 5 PM your local time.