Health Program Representative I

Elevance Health•Las Vegas, NV

3d•Remote

About The Position

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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. As a Health Program Representative I, you are responsible for providing initial contact between distinct Care Management programs and specific identified members. Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features. 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. Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. Performs other duties as assigned.

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.
Strong verbal and written communication skills, both with virtual and in-person interactions.
Attentive to details, critical thinker, and a problem-solver.

Nice To Haves

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

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.
Ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
Maintains focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
Demonstrates empathy and persistence to resolve caller issues completely.
Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
Performs other duties as assigned.

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.
Comprehensive benefits package.
Incentive and recognition programs.
Equity stock purchase.
401k contribution.
Medical, dental, vision, short and long term disability benefits.
Stock purchase plan.
Life insurance.
Wellness programs.
Financial education resources.