Healthcare Advocate

4 weeks ago


San Diego, California, United States Serene Health Full time
Job Title: Healthcare Representative

Job Summary:

The Healthcare Representative plays a vital role in facilitating the onboarding process for health plan members, ensuring a seamless transition into new benefits. This position requires strong communication skills, a deep understanding of various health plans, and the ability to navigate multiple EMR systems.

Key Responsibilities:

  • Verify eligibility status and onboard health plan members for additional benefits.
  • Engage with members and their family/support persons to discuss new health plan benefits.
  • Navigate and utilize multiple health plans' EMR systems to ensure efficient care coordination.
  • Provide empathetic and respectful interactions with members, adhering to their religious and cultural preferences.
  • Collaborate with the care coordination team to develop health interventions and interact with involved departments to expedite scheduling and completion of healthcare consults.
  • Ensure compliance with organizational guidelines, healthcare laws, and regulations, including HIPAA, by maintaining high standards of care.
  • Maintain quality service by enforcing organization standards.
  • Perform additional duties as needed.

Requirements / Qualifications:

  • Bachelor's degree in Healthcare Administration or High school diploma / GED with healthcare clinical practice.
  • Minimum 1 year of healthcare and/or sales and marketing experience.
  • Bilingual in English and Spanish (preferred).
  • Excellent communication, interpersonal, customer service, and organizational skills.
  • Proficient computer skills and experience with Microsoft Office.
  • Maintain empathy and professionalism while contacting members and families.

Working Environment / Physical Requirements:

  • Prolonged periods of sitting at an office desk on the computer.
  • Lifting: Able to lift up to 15lbs.

Benefits:

Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:

Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.

Short & Long-Term Disability Benefits: Protection when you need it most.

Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.

Flexible Spending Accounts: Manage your finances with flexibility.

Employee Assistance Program (EAP): Support when life throws challenges your way.

401(K): Building your financial future with us. Effective after 1 year of employment.

Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.

Paid Holidays: Quality time to enjoy celebrations.

Employee Referral Program: Share the opportunities and reap the rewards.

Company Discount Program: Enjoy savings on everyday expenses and memberships.

Equal Employment Opportunity:

Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.

Pre-Employment:

Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.


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