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Member Services Specialist

4 months ago

Harrisburg, United States AmeriHealth Caritas Full time

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

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care 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 would like to hear 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.

**Responsibilities**:
Member Services Specialists are responsible for the intake processes of PerformCare. They are the first point of contact for Members accessing the company. This position is responsible for answering the telephone and explaining the operation of PerformCare to our Members when they call; Completing intake information regarding the member; Explaining procedures for accessing services to Members; Coordinating/Interfacing with the Medical Assistance Transportation Program (MATP), as necessary, to assist Members in securing transportation to scheduled appointments; Completing bed searches, as necessary, for IP and SA bed requests; Addressing Member complaints through the initialization of the PerformCare Grievance and Complaint process; Explaining a Member’s rights as requested; Providing additional resources to the Member such as a Member Handbook and list of in-plan providers from the Member’s geographic region and completing data entry of requests and authorizations.

**Education/Experience**:

- Bachelor’s Degree from an accredited college or university required.
- 1-3 years Behavioral Health experience preferred.
- Excellent written and verbal communication skills with the ability to respond sensitively to member’s requests preferred.
- Previous customer service in a call center environment and data entry experience preferred.
- At least one year of experience in mental health and/or human services required; or equivalent background and experience that would translate well into this position.
- Ability to communicate well verbally and in writing with Members and all other internal and external customers.
- Ability to use PC’s in a Windows based environment.
- Remote, work from home.

**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 including 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 1, 401(k) Tuition reimbursement and more.